Provider Demographics
NPI:1417284324
Name:ALAVERDIAN, ARTUR (MD)
Entity Type:Individual
Prefix:
First Name:ARTUR
Middle Name:
Last Name:ALAVERDIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ARTUR
Other - Middle Name:
Other - Last Name:ALLAKHVERDOV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:410 LAKEVILLE ROAD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040
Mailing Address - Country:US
Mailing Address - Phone:516-465-5400
Mailing Address - Fax:516-465-5454
Practice Address - Street 1:410 LAKEVILLE ROAD
Practice Address - Street 2:SUITE 107
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040
Practice Address - Country:US
Practice Address - Phone:516-465-5400
Practice Address - Fax:516-465-5454
Is Sole Proprietor?:No
Enumeration Date:2009-11-13
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244724207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine