Provider Demographics
NPI:1518214626
Name:CAN, AHMET SELCUK (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMET
Middle Name:SELCUK
Last Name:CAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SELCUK
Other - Middle Name:
Other - Last Name:CAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2408 INVERNESS DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-6314
Mailing Address - Country:US
Mailing Address - Phone:732-341-9965
Mailing Address - Fax:732-341-9588
Practice Address - Street 1:40 BEY LEA ROAD
Practice Address - Street 2:BLDG B SUITE B202
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2989
Practice Address - Country:US
Practice Address - Phone:732-341-9965
Practice Address - Fax:732-341-9588
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09164300207RE0101X
NY263414207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103393512Medicaid
NY04840364Medicaid