Provider Demographics
NPI:1477653079
Name:KEHAYAN, VAHAN ALEXANDER (ED D)
Entity Type:Individual
Prefix:DR
First Name:VAHAN
Middle Name:ALEXANDER
Last Name:KEHAYAN
Suffix:
Gender:M
Credentials:ED D
Other - Prefix:DR
Other - First Name:V.
Other - Middle Name:ALEX
Other - Last Name:KEHAYAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ED D
Mailing Address - Street 1:163 DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-4407
Mailing Address - Country:US
Mailing Address - Phone:201-445-7287
Mailing Address - Fax:201-445-6569
Practice Address - Street 1:163 DAYTON ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-4407
Practice Address - Country:US
Practice Address - Phone:201-445-7287
Practice Address - Fax:201-445-6569
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1463103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist