Provider Demographics
NPI:1124139829
Name:TUYSUZOGLU, GOZEN (MD)
Entity type:Individual
Prefix:
First Name:GOZEN
Middle Name:
Last Name:TUYSUZOGLU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1889
Mailing Address - Country:US
Mailing Address - Phone:201-835-8902
Mailing Address - Fax:212-939-8013
Practice Address - Street 1:506 LENOX AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1802
Practice Address - Country:US
Practice Address - Phone:201-835-8902
Practice Address - Fax:212-939-8013
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236320-1207K00000X, 208000000X
NY236320207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBT7516961OtherDEA
NYBT7516961OtherDEA