Provider Demographics
NPI:1043748031
Name:OHANYAN, SARGIS (MD)
Entity type:Individual
Prefix:DR
First Name:SARGIS
Middle Name:
Last Name:OHANYAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3604
Mailing Address - Country:US
Mailing Address - Phone:617-686-7960
Mailing Address - Fax:
Practice Address - Street 1:2880 OLD DIXWELL AVE STE 201
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3144
Practice Address - Country:US
Practice Address - Phone:617-686-7960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-02
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT73515208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3137087Medicaid