Provider Demographics
NPI:1326250374
Name:ELZARIAN, EDWARD JAMES (MS PHARM)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JAMES
Last Name:ELZARIAN
Suffix:
Gender:M
Credentials:MS PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MILL CREEK TER
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23663-1820
Mailing Address - Country:US
Mailing Address - Phone:757-722-0535
Mailing Address - Fax:757-736-1217
Practice Address - Street 1:12 MILL CREEK TER
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23663-1820
Practice Address - Country:US
Practice Address - Phone:757-722-0535
Practice Address - Fax:757-736-1217
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022054231835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric