Provider Demographics
NPI:1497758585
Name:NALJIAN, VAHE G (MD)
Entity Type:Individual
Prefix:
First Name:VAHE
Middle Name:G
Last Name:NALJIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-0270
Mailing Address - Country:US
Mailing Address - Phone:631-264-2035
Mailing Address - Fax:631-264-1418
Practice Address - Street 1:2525 KINGS HWY
Practice Address - Street 2:NEW YORK COMMUNITY HOSPITAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1705
Practice Address - Country:US
Practice Address - Phone:201-788-5200
Practice Address - Fax:201-760-9345
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY195813-1207L00000X
NJ25MA06115800207L00000X
CAC51505207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8468109Medicaid
NJ046650Medicare ID - Type Unspecified
F91098Medicare UPIN