Provider Demographics
NPI:1760873046
Name:TARHAN, OZLEM (PA)
Entity Type:Individual
Prefix:
First Name:OZLEM
Middle Name:
Last Name:TARHAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 MORRIS PARK AVE
Mailing Address - Street 2:APT 3R
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-3683
Mailing Address - Country:US
Mailing Address - Phone:908-367-0340
Mailing Address - Fax:
Practice Address - Street 1:3201 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-2625
Practice Address - Country:US
Practice Address - Phone:718-677-0109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
018173363A00000X
NY018173363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant