Provider Demographics
NPI:1770044414
Name:ANDRIASYAN, HAYK ZAR (LMT)
Entity Type:Individual
Prefix:
First Name:HAYK
Middle Name:ZAR
Last Name:ANDRIASYAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MYSTIC CT
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-2305
Mailing Address - Country:US
Mailing Address - Phone:732-766-0897
Mailing Address - Fax:
Practice Address - Street 1:45 SOUTH AVE W STE 201
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2686
Practice Address - Country:US
Practice Address - Phone:732-766-0897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00027100225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty