Provider Demographics
NPI:1609849249
Name:MURACHANIAN, RICHARD J (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:MURACHANIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1515 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:PT PLEASANT
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-3056
Mailing Address - Country:US
Mailing Address - Phone:732-295-0072
Mailing Address - Fax:732-295-0224
Practice Address - Street 1:1515 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:PT PLEASANT
Practice Address - State:NJ
Practice Address - Zip Code:08742-3056
Practice Address - Country:US
Practice Address - Phone:732-295-0072
Practice Address - Fax:732-295-0224
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04870700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3345203Medicaid
NJ3345203Medicaid
NJ452401Medicare ID - Type Unspecified
NJ110172485OtherRAILROAD MEDICARE