Provider Demographics
NPI:1659710242
Name:ORGUN, IBRAHIM N (MD)
Entity Type:Individual
Prefix:MR
First Name:IBRAHIM
Middle Name:N
Last Name:ORGUN
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 1:44 CRAIGEMORE CIR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-3417
Mailing Address - Country:US
Mailing Address - Phone:860-673-4055
Mailing Address - Fax:
Practice Address - Street 1:44 CRAIGEMORE CIR
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3417
Practice Address - Country:US
Practice Address - Phone:860-673-4055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0093612084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry