Provider Demographics
NPI:1134273147
Name:BORTECEN, KEREM HAKKI (MD, PHD, MBA, FACS)
Entity type:Individual
Prefix:
First Name:KEREM
Middle Name:HAKKI
Last Name:BORTECEN
Suffix:
Gender:M
Credentials:MD, PHD, MBA, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 E 60TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1006
Mailing Address - Country:US
Mailing Address - Phone:888-286-6600
Mailing Address - Fax:
Practice Address - Street 1:14 E 60TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1006
Practice Address - Country:US
Practice Address - Phone:888-286-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2017-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426048208600000X
NH13736208600000X
CAA80625208600000X
MI4301079457208600000X
OH35097760208600000X
IL036129009208600000X
CT51339208600000X
NY267935208600000X, 208D00000X
TXQ0609208600000X
FLME119874208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036129009Medicaid