Provider Demographics
NPI:1578653507
Name:OKTAY, KUTLUK H (MD, PHD)
Entity Type:Individual
Prefix:
First Name:KUTLUK
Middle Name:H
Last Name:OKTAY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 MAMARONECK AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-1646
Mailing Address - Country:US
Mailing Address - Phone:877-492-3666
Mailing Address - Fax:
Practice Address - Street 1:600 MAMARONECK AVE STE 110
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528
Practice Address - Country:US
Practice Address - Phone:877-492-3666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209193207VE0102X
MNXXXXXXXXXXXXX207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF57330Medicare UPIN