Provider Demographics
NPI:1073547311
Name:BOYAJIAN, STEPHEN S (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:S
Last Name:BOYAJIAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 EXECUTIVE DRIVE
Mailing Address - Street 2:SUITE 430
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3431
Mailing Address - Country:US
Mailing Address - Phone:856-489-9822
Mailing Address - Fax:856-489-9877
Practice Address - Street 1:1 EXECUTIVE DRIVE
Practice Address - Street 2:SUITE 430
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3431
Practice Address - Country:US
Practice Address - Phone:856-489-9822
Practice Address - Fax:856-489-9877
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB04736200208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ447990Medicare ID - Type Unspecified
NJE22020Medicare UPIN