Provider Demographics
NPI:1992142319
Name:DJOUGARIAN, ALINA (MD)
Entity type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:DJOUGARIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 BROADWAY
Mailing Address - Street 2:SUITE 114
Mailing Address - City:NEW JERSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07514
Mailing Address - Country:US
Mailing Address - Phone:973-742-4747
Mailing Address - Fax:
Practice Address - Street 1:4300 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5704
Practice Address - Country:US
Practice Address - Phone:516-210-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-24
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271473207WX0009X
NJ25MA10203100207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist