Individual
RAIDA DOVLATYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
300 MARKET ST, SADDLE BROOK, NJ 07663-5309
(201) 368-6019
Mailing address
4714 GETTYSBURG RD, LEGAL DEPARTMENT, MECHANICSBURG, PA 17055-4325
(717) 972-1100
(717) 975-9981
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
25MA05544300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0050954
—
NJ
Enumeration date
10/12/2005
Last updated
02/18/2011
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