1982652921 NPI number — GARO MEGERIAN M.D.

Table of content: GARO MEGERIAN M.D. (NPI 1982652921)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982652921 NPI number — GARO MEGERIAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEGERIAN
Provider First Name:
GARO
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982652921
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/06/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 22581
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10087-2581
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-482-4795
Provider Business Mailing Address Fax Number:
856-528-3117

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
450 CRESSON BLVD
Provider Second Line Business Practice Location Address:
STE. 300
Provider Business Practice Location Address City Name:
OAKS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-831-0200
Provider Business Practice Location Address Fax Number:
484-831-0209
Provider Enumeration Date:
05/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207VM0101X , with the licence number:  MD043261L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 531740 . This is a "BC/BS SHIELD HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 02640 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0012897910021 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1652893 . This is a "BC/BS HIGHMARK GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0218979116 . This is a "AMERICHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 33657 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 33658 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 33659 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 30018990 . This is a "KEYSTONE MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 4459215 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0734800000 . This is a "BC/BS KEY, PER. GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 30018989 . This is a "KEYSTONE MERCY GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3716964 . This is a "AETNA US HEALTHCARE HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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