Provider Demographics
NPI:1114986940
Name:MINASSIAN, HAIG (MD)
Entity Type:Individual
Prefix:
First Name:HAIG
Middle Name:
Last Name:MINASSIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RIVERVIEW PLZ
Mailing Address - Street 2:DEPT OF PATHOLOGY
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1864
Mailing Address - Country:US
Mailing Address - Phone:732-530-2347
Mailing Address - Fax:732-345-2045
Practice Address - Street 1:1 RIVERVIEW PLZ
Practice Address - Street 2:DEPT OF PATHOLOGY
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1864
Practice Address - Country:US
Practice Address - Phone:732-530-2347
Practice Address - Fax:732-345-2045
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05693400207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6325807Medicaid
NJ198552Medicare ID - Type Unspecified
NJ6325807Medicaid