Provider Demographics
NPI:1023296936
Name:KASARYAN, HRACH IKE (DO)
Entity type:Individual
Prefix:DR
First Name:HRACH
Middle Name:IKE
Last Name:KASARYAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:400 FRANK W BURR BLVD
Mailing Address - Street 2:# 22, SECOND FLOOR
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-6839
Mailing Address - Country:US
Mailing Address - Phone:201-928-2300
Mailing Address - Fax:201-692-3263
Practice Address - Street 1:400 FRANK W BURR BLVD
Practice Address - Street 2:#22, SECOND FLOOR
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-6839
Practice Address - Country:US
Practice Address - Phone:201-928-2300
Practice Address - Fax:201-692-3263
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY246961-1207R00000X
NJ25MB08886200207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine