Provider Demographics
NPI:1154394310
Name:JARAHIAN, GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:JARAHIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 MERCER AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07762-2060
Mailing Address - Country:US
Mailing Address - Phone:732-359-6126
Mailing Address - Fax:
Practice Address - Street 1:1640 ROUTE 88
Practice Address - Street 2:SUITE 203
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3036
Practice Address - Country:US
Practice Address - Phone:732-458-7777
Practice Address - Fax:732-458-6741
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA03837500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223360408-003OtherQUALCARE
NJ1129601Medicaid
NJ2K1627OtherHEALTHNET
NJP523191OtherOXFORD
NJ223360408-003OtherQUALCARE
NJ1129601Medicaid