Provider Demographics
NPI:1558990846
Name:KOCASARAC, CAN (MD)
Entity Type:Individual
Prefix:
First Name:CAN
Middle Name:
Last Name:KOCASARAC
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:UPMC EYE CENTER 203 LOTHROP STREET
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:412-864-3283
Mailing Address - Fax:
Practice Address - Street 1:203 LOTHROP ST FL 8
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2548
Practice Address - Country:US
Practice Address - Phone:312-996-7774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PALT000884207WX0109X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program