Provider Demographics
NPI:1205982154
Name:TUNCEL, MERYEM (MD)
Entity type:Individual
Prefix:
First Name:MERYEM
Middle Name:
Last Name:TUNCEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MERYEM
Other - Middle Name:
Other - Last Name:KARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-2212
Mailing Address - Country:US
Mailing Address - Phone:860-679-7503
Mailing Address - Fax:860-679-1610
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:NEPHROLOGY
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-3835
Practice Address - Country:US
Practice Address - Phone:860-679-2160
Practice Address - Fax:860-679-1042
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT051509207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1205982154Medicaid