Provider Demographics
NPI:1417112731
Name:BOZDOGAN, ULAS (MD)
Entity Type:Individual
Prefix:
First Name:ULAS
Middle Name:
Last Name:BOZDOGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 PROSPECT AVE
Mailing Address - Street 2:SUITE 15
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2255
Mailing Address - Country:US
Mailing Address - Phone:201-880-6181
Mailing Address - Fax:201-880-6184
Practice Address - Street 1:140 PROSPECT AVE
Practice Address - Street 2:SUITE 15
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2255
Practice Address - Country:US
Practice Address - Phone:201-880-6181
Practice Address - Fax:201-880-6184
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036120335207V00000X
NJ25MA08358700207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMA59792OtherNEW JERSEY LICENSE
ILLICENSE NUMBEROther036120335