Provider Demographics
NPI:1740738798
Name:VARDY ORTHODONTICS P.C.
Entity Type:Organization
Organization Name:VARDY ORTHODONTICS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:H
Authorized Official - Last Name:VARDY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-579-6881
Mailing Address - Street 1:130 W 78TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6728
Mailing Address - Country:US
Mailing Address - Phone:212-579-6881
Mailing Address - Fax:212-579-6871
Practice Address - Street 1:130 W 78TH ST STE B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6728
Practice Address - Country:US
Practice Address - Phone:212-579-6881
Practice Address - Fax:212-579-6871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0435391223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty