Provider Demographics
NPI:1770597015
Name:ZIYALAN, MUSTAFA S (MD)
Entity type:Individual
Prefix:
First Name:MUSTAFA
Middle Name:S
Last Name:ZIYALAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 5TH AVE
Mailing Address - Street 2:SUITE 1103
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6601
Mailing Address - Country:US
Mailing Address - Phone:212-252-2331
Mailing Address - Fax:
Practice Address - Street 1:303 5TH AVE
Practice Address - Street 2:SUITE 1103
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6601
Practice Address - Country:US
Practice Address - Phone:212-252-2331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2052902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY54M441Medicare ID - Type Unspecified
NYG57637Medicare UPIN