Individual
DR. IGOR Z AVAGYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
397 SKI TRL, KINNELON, NJ 07405-2247
(917) 494-8226
(212) 426-1409
Mailing address
397 SKI TRL, KINNELON, NJ 07405-2247
(917) 494-8226
(212) 426-1409
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
218312
NY
207R00000X
Internal Medicine Physician
Primary
25MA07456200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02088017
—
NY
Enumeration date
08/05/2006
Last updated
04/16/2016
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