Provider Demographics
NPI:1982652921
Name:MEGERIAN, GARO (MD)
Entity Type:Individual
Prefix:
First Name:GARO
Middle Name:
Last Name:MEGERIAN
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:PO BOX 22581
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-2581
Mailing Address - Country:US
Mailing Address - Phone:610-482-4795
Mailing Address - Fax:856-528-3117
Practice Address - Street 1:450 CRESSON BLVD
Practice Address - Street 2:STE. 300
Practice Address - City:OAKS
Practice Address - State:PA
Practice Address - Zip Code:19456
Practice Address - Country:US
Practice Address - Phone:484-831-0200
Practice Address - Fax:484-831-0209
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043261L207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA531740OtherBC/BS SHIELD HIGHMARK
PA02640OtherHEALTH PARTNERS
PA0012897910021Medicaid
PA1652893OtherBC/BS HIGHMARK GROUP
PA0218979116OtherAMERICHOICE
PA33657OtherHEALTH PARTNERS
PA33658OtherHEALTH PARTNERS
PA33659OtherHEALTH PARTNERS
PA30018990OtherKEYSTONE MERCY
PA4459215OtherAETNA US HEALTHCARE
PA0734800000OtherBC/BS KEY, PER. GROUP
PA30018989OtherKEYSTONE MERCY GROUP
PA3716964OtherAETNA US HEALTHCARE HMO
F89861Medicare UPIN
531740TGWMedicare ID - Type Unspecified