Provider Demographics
NPI:1437516523
Name:VARUZHAN DOVLATYAN, PHYSICIAN, PLLC
Entity Type:Organization
Organization Name:VARUZHAN DOVLATYAN, PHYSICIAN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VARUZHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOVLATYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-857-4011
Mailing Address - Street 1:535 5TH AVE
Mailing Address - Street 2:SUITE 906
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-3620
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:535 5TH AVE
Practice Address - Street 2:SUITE 906
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-3620
Practice Address - Country:US
Practice Address - Phone:201-857-4011
Practice Address - Fax:201-389-3498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207890207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty