Provider Demographics
NPI:1811928369
Name:DOVLATYAN, VARUZHAN (MD)
Entity type:Individual
Prefix:
First Name:VARUZHAN
Middle Name:
Last Name:DOVLATYAN
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 1:267 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4511
Mailing Address - Country:US
Mailing Address - Phone:201-857-4011
Mailing Address - Fax:201-389-3498
Practice Address - Street 1:20 E 46TH ST
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-2417
Practice Address - Country:US
Practice Address - Phone:646-490-5475
Practice Address - Fax:201-389-3498
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2078902081P2900X, 208VP0000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01777339Medicaid
NY01777339Medicaid
G62992Medicare UPIN