Provider Demographics
NPI:1205886850
Name:HAGOPIAN, GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
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 1:755 N BROADWAY STE 560
Mailing Address - Street 2:
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591-1077
Mailing Address - Country:US
Mailing Address - Phone:914-366-3640
Mailing Address - Fax:914-840-1405
Practice Address - Street 1:755 N BROADWAY STE 560
Practice Address - Street 2:
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-1077
Practice Address - Country:US
Practice Address - Phone:914-366-3640
Practice Address - Fax:914-840-1405
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209049-1207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01872715Medicaid
NY2008532OtherUHC,MSNYU,HEALTH TOP TIER
NY4125588OtherMVP
NY6547288OtherCIGNA/HMO/PPO/POS/INDEMNI
NYP3600640OtherOXF, LIBERTY,FREEDOM,MEDI
NY000000090408OtherGHI -HMO
NY0204239OtherGHI-CBP,PPO,PREMIER PPO,
NY2008532OtherUHC,HMO,POS,PPO,EPO,INDEM
NY4C7901OtherHEALTHNET-HMO,PLATINUM,PP
NY5265TVMedicare PIN
NY2008532OtherUHC,HMO,POS,PPO,EPO,INDEM
NYP3600640OtherOXF, LIBERTY,FREEDOM,MEDI