Provider Demographics
NPI:1043664758
Name:EVREN, SEVAN (DO)
Entity Type:Individual
Prefix:MR
First Name:SEVAN
Middle Name:
Last Name:EVREN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 TENTH STREET
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301
Mailing Address - Country:US
Mailing Address - Phone:718-278-4151
Mailing Address - Fax:716-278-4706
Practice Address - Street 1:533 TENTH STREET
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301
Practice Address - Country:US
Practice Address - Phone:718-278-4151
Practice Address - Fax:716-278-4706
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2019-12-20
Deactivation Date:2016-12-14
Deactivation Code:
Reactivation Date:2017-03-15
Provider Licenses
StateLicense IDTaxonomies
NY297139207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine