Provider Demographics
NPI:1295035731
Name:SYLVIE D KHORENIAN MD PC
Entity Type:Organization
Organization Name:SYLVIE D KHORENIAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EMPLOYER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYLVIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:KHORENIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-503-0302
Mailing Address - Street 1:630 E PALISADE AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-1842
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:630 E PALISADE AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-1842
Practice Address - Country:US
Practice Address - Phone:201-503-0302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty