| Herman Ayvazyan | |
|
450 Veterans Memorial Pkwy # 12 East Providence RI 02914-5300 | |
| (401) 434-6464 | |
| (401) 438-1890 |
| Full Name | Herman Ayvazyan |
|---|---|
| Speciality | Internal Medicine |
| Location | 450 Veterans Memorial Pkwy # 12, East Providence, Rhode Island |
| Authorized Official Name and Position | Herman Ayvazyan (DOCTOR) |
| Authorized Official Contact | 4014346464 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Herman Ayvazyan 450 Veterans Memorial Pkwy # 12 East Providence RI 02914-5300 Ph: (401) 434-6464 | Herman Ayvazyan 450 Veterans Memorial Pkwy # 12 East Providence RI 02914-5300 Ph: (401) 434-6464 |
| NPI Number | 1619134921 |
|---|---|
| Provider Enumeration Date | 05/22/2008 |
| Last Update Date | 05/16/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619134921 | NPI | - | NPPES |
| 9001194 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 7061 (Rhode Island) | Primary |
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