Provider Demographics
NPI:1982657656
Name:DOGANAY, KAZIM (MD PLLC)
Entity Type:Individual
Prefix:
First Name:KAZIM
Middle Name:
Last Name:DOGANAY
Suffix:
Gender:M
Credentials:MD PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4911
Mailing Address - Country:US
Mailing Address - Phone:631-661-8836
Mailing Address - Fax:631-661-8304
Practice Address - Street 1:747 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4911
Practice Address - Country:US
Practice Address - Phone:631-661-8836
Practice Address - Fax:631-661-8304
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185940174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG36025Medicare UPIN
NY61L091Medicare PIN
NY61L09JW531Medicare PIN