Provider Demographics
NPI:1225002249
Name:OZKAN, SUSAN (PA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:OZKAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 MATHEWS RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:NH
Mailing Address - Zip Code:03222
Mailing Address - Country:US
Mailing Address - Phone:603-867-0152
Mailing Address - Fax:
Practice Address - Street 1:1 ELLIOT WAY
Practice Address - Street 2:EMERGENCY MEDICINE SPECIALISTS OF THE ELLIOT
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3547
Practice Address - Country:US
Practice Address - Phone:603-663-2830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0322P363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30330260Medicaid
NHAP1007Medicare ID - Type Unspecified
NH30330260Medicaid