Provider Demographics
NPI:1700886181
Name:TARPINIAN, VAGHENAG VAHE (MD)
Entity Type:Individual
Prefix:
First Name:VAGHENAG
Middle Name:VAHE
Last Name:TARPINIAN
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 1:104 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:PA
Mailing Address - Zip Code:18013-2504
Mailing Address - Country:US
Mailing Address - Phone:610-588-3133
Mailing Address - Fax:610-588-6251
Practice Address - Street 1:104 S 2ND ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:PA
Practice Address - Zip Code:18013-2504
Practice Address - Country:US
Practice Address - Phone:610-588-3133
Practice Address - Fax:610-588-6251
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038095-E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001556643005Medicaid
PA821939OtherPENNSYLVANIA BLUE SHIELD
PA0015566430013Medicaid
PA50081521OtherCAPITAL BLUE CROSS
C57641Medicare UPIN
PA0015566430013Medicaid
PA0015566430013Medicaid