Provider Demographics
NPI:1679618094
Name:BAJAKIAN, BRYAN KAREKIN (DC)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:KAREKIN
Last Name:BAJAKIAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-5912
Mailing Address - Country:US
Mailing Address - Phone:201-488-1008
Mailing Address - Fax:201-488-7770
Practice Address - Street 1:547 MAIN ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-5912
Practice Address - Country:US
Practice Address - Phone:201-488-1008
Practice Address - Fax:201-488-7770
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00262100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJBA449686Medicare ID - Type Unspecified