Provider Demographics
NPI:1982665683
Name:HAGOPIAN, VAHE (MD)
Entity Type:Individual
Prefix:DR
First Name:VAHE
Middle Name:
Last Name:HAGOPIAN
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 706
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-0706
Mailing Address - Country:US
Mailing Address - Phone:201-923-1078
Mailing Address - Fax:
Practice Address - Street 1:1117 ROUTE 46
Practice Address - Street 2:SUITE 303
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2449
Practice Address - Country:US
Practice Address - Phone:201-923-1078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA62723207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6850600Medicaid
NJG42542Medicare UPIN
NJ529347Medicare ID - Type Unspecified