Provider Demographics
NPI:1912339144
Name:ARA MANOUGIAN MD LLC
Entity Type:Organization
Organization Name:ARA MANOUGIAN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANOUGIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-265-2184
Mailing Address - Street 1:446 E RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-5625
Mailing Address - Country:US
Mailing Address - Phone:201-265-2184
Mailing Address - Fax:
Practice Address - Street 1:446 E RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5625
Practice Address - Country:US
Practice Address - Phone:201-265-2184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03162800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty