Provider Demographics
NPI:1730278904
Name:TCHORBAJIAN, KOURKIN (MD)
Entity Type:Individual
Prefix:
First Name:KOURKIN
Middle Name:
Last Name:TCHORBAJIAN
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 1:1530 SAINT GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2750
Mailing Address - Country:US
Mailing Address - Phone:732-382-7473
Mailing Address - Fax:732-382-9045
Practice Address - Street 1:1530 SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2750
Practice Address - Country:US
Practice Address - Phone:732-382-7473
Practice Address - Fax:732-382-9045
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04466600207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJHS201OtherOXFORD
NJF03774OtherHEALTHNET
NJ1227571OtherUNITED HEALTHCARE
NJ0230008OtherGHI
NJ57D861OtherWELLCHOICE/ EMPIRE BC/BS
NJ180026962OtherRAILROAD MEDICARE
NJ4041478OtherCIGNA
NJ4294314OtherAETNA
NJ0230008OtherGHI
NJ4041478OtherCIGNA