Provider Demographics
NPI:1932271509
Name:OZCAN, ISMAIL (MD)
Entity Type:Individual
Prefix:DR
First Name:ISMAIL
Middle Name:
Last Name:OZCAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ISMAIL
Other - Middle Name:
Other - Last Name:OZCAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2762 MILBURN AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-4117
Mailing Address - Country:US
Mailing Address - Phone:516-705-4114
Mailing Address - Fax:
Practice Address - Street 1:2762 MILBURN AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-4117
Practice Address - Country:US
Practice Address - Phone:516-705-4114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242241207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02838420Medicaid
NY38264Medicare PIN
NY3353Q1Medicare UPIN
NY02838420Medicaid