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General NPI Number Information
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NPI Number | 1770044414
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Entity Type | Individual
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Provider Name | HAYK ZAR ANDRIASYAN LMT
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Gender | Male
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 03/26/2019
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Provider Practice Location Address
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Address Line | 45 SOUTH AVE W STE 201
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City | CRANFORD
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State | NJ
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Zip | 07016-2686
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Country | US
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Telephone | 732-766-0897
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Fax |
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Provider Business Mailing Address
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Address Line | 4 MYSTIC CT
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City | SAYREVILLE
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State | NJ
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Zip | 08872-2305
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Country | US
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Telephone | 732-766-0897
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 18KT00027100
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License Number State | NJ
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