Provider Demographics
NPI:1023072469
Name:HOBAYAN, EDGAR RAMOS (MD)
Entity type:Individual
Prefix:
First Name:EDGAR
Middle Name:RAMOS
Last Name:HOBAYAN
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 1:1907 PARK AVE
Mailing Address - Street 2:STE 203
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080
Mailing Address - Country:US
Mailing Address - Phone:908-561-7739
Mailing Address - Fax:908-757-3671
Practice Address - Street 1:1907 PARK AVE
Practice Address - Street 2:STE 203
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080
Practice Address - Country:US
Practice Address - Phone:908-561-7739
Practice Address - Fax:908-757-3671
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA03151000208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3638901Medicaid
NJ144208Medicare ID - Type Unspecified
C54333Medicare UPIN