Provider Demographics
NPI:1336207364
Name:HAZARIAN, ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:
Last Name:HAZARIAN
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 1:4338 44TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11104-4608
Mailing Address - Country:US
Mailing Address - Phone:718-786-2734
Mailing Address - Fax:718-786-5304
Practice Address - Street 1:4338 44TH ST
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11104-4608
Practice Address - Country:US
Practice Address - Phone:718-786-2734
Practice Address - Fax:718-786-5304
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219504207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02105599Medicaid
NY04232Medicare PIN
NYH25490Medicare UPIN