Provider Demographics
NPI:1932736634
Name:KAZARIAN, GREGORY STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:STEPHEN
Last Name:KAZARIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GREG
Other - Middle Name:STEPHEN
Other - Last Name:KAZARIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2 MARISSA CIR
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-2674
Mailing Address - Country:US
Mailing Address - Phone:508-742-7957
Mailing Address - Fax:
Practice Address - Street 1:2 MARISSA CIR
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-2674
Practice Address - Country:US
Practice Address - Phone:508-742-7957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program