Provider Demographics
NPI:1972566263
Name:SIMONIAN, ARMEN JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:ARMEN
Middle Name:JOHN
Last Name:SIMONIAN
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 1:3 JEFFERSON PL
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-4220
Mailing Address - Country:US
Mailing Address - Phone:609-737-4396
Mailing Address - Fax:609-695-5141
Practice Address - Street 1:TWO CAPITAL WAY
Practice Address - Street 2:SUITE 487
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2520
Practice Address - Country:US
Practice Address - Phone:609-818-1900
Practice Address - Fax:609-818-1908
Is Sole Proprietor?:No
Enumeration Date:2006-04-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA060739207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2549843OtherAETNA
NJ7208804Medicaid
NJ0892306000OtherAMERIHEALTH
NJ100015221Medicare PIN
NJ7208804Medicaid
NJ848746PY5Medicare PIN