Provider Demographics
NPI:1841302882
Name:CUBUKCU-DIMOPULO, OLCAY (MD)
Entity type:Individual
Prefix:
First Name:OLCAY
Middle Name:
Last Name:CUBUKCU-DIMOPULO
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 1:1024 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-3612
Mailing Address - Country:US
Mailing Address - Phone:914-637-4646
Mailing Address - Fax:914-637-4646
Practice Address - Street 1:1024 NORTH AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-3612
Practice Address - Country:US
Practice Address - Phone:914-637-4646
Practice Address - Fax:914-637-4646
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214880207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology