Provider Demographics
NPI:1225062334
Name:ACIKGOZ, GUNSEL (MD)
Entity Type:Individual
Prefix:
First Name:GUNSEL
Middle Name:
Last Name:ACIKGOZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GUNSEL
Other - Middle Name:
Other - Last Name:VURAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3900 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4551
Mailing Address - Country:US
Mailing Address - Phone:215-823-5800
Mailing Address - Fax:
Practice Address - Street 1:3900 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4551
Practice Address - Country:US
Practice Address - Phone:215-823-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10007745207U00000X, 2085P0229X
PAMD427439207U00000X, 2085P0229X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101939880Medicaid
MD4092520Medicaid
NJ0134473Medicaid
NJ0134473Medicaid
NJ0134473Medicaid
DE018168A34Medicare PIN