Provider Demographics
NPI:1558654350
Name:DUZENLI, PELIN (MD)
Entity type:Individual
Prefix:MS
First Name:PELIN
Middle Name:
Last Name:DUZENLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12420 WARWICK BLVD
Mailing Address - Street 2:BLDG 7 SUITE C
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-3001
Mailing Address - Country:US
Mailing Address - Phone:757-594-3900
Mailing Address - Fax:757-595-0649
Practice Address - Street 1:860 OMNI BLVD
Practice Address - Street 2:STE 303
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4434
Practice Address - Country:US
Practice Address - Phone:757-232-8769
Practice Address - Fax:757-232-8875
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01012585352084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program