Provider Demographics
NPI:1649227174
Name:KARAKASHIAN, GARY V (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:V
Last Name:KARAKASHIAN
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 1:107 MONMOUTH RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1000
Mailing Address - Country:US
Mailing Address - Phone:732-544-9200
Mailing Address - Fax:732-449-3272
Practice Address - Street 1:107 MONMOUTH RD
Practice Address - Street 2:SUITE 108
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1000
Practice Address - Country:US
Practice Address - Phone:732-544-9200
Practice Address - Fax:732-449-3272
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA51823174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMS088OtherOXFORD
NJ4281192OtherAETNA
NJ4511701Medicaid
NJ4281192OtherAETNA
NJMS088OtherOXFORD