Provider Demographics
NPI:1821319765
Name:HAZARIAN MEDICAL ASSOCIATES PLLC
Entity Type:Organization
Organization Name:HAZARIAN MEDICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:HAZARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-786-2734
Mailing Address - Street 1:4338 44TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-4608
Mailing Address - Country:US
Mailing Address - Phone:718-786-2734
Mailing Address - Fax:718-786-5304
Practice Address - Street 1:4338 44TH ST
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-4608
Practice Address - Country:US
Practice Address - Phone:718-786-2734
Practice Address - Fax:718-786-5304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219504207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02105599Medicaid
NYH25490Medicare UPIN
NY04232Medicare PIN