Provider Demographics
NPI:1285821892
Name:ERTAMAY, AYSE ZUHAL (PA-C)
Entity Type:Individual
Prefix:MS
First Name:AYSE
Middle Name:ZUHAL
Last Name:ERTAMAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:AYZE
Other - Middle Name:ZUHAL
Other - Last Name:ERSAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:660 WHITE PLAINS RD FL ENTA4
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5139
Mailing Address - Country:US
Mailing Address - Phone:914-333-5801
Mailing Address - Fax:
Practice Address - Street 1:7831 37TH AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6641
Practice Address - Country:US
Practice Address - Phone:718-424-0061
Practice Address - Fax:718-424-0045
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AS0400X, 363AM0700X
NY004531-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical