Healthcare Provider Details

I. General information

NPI: 1356324438
Provider Name (Legal Business Name): MERT OZAN BAHTIYAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 YORK ST YALE- NEW HAVEN HOSPITAL EAST PAVILION 4TH FLOOR
NEW HAVEN CT
06510-3220
US

IV. Provider business mailing address

300 GEORGE ST 6TH FLOOR
NEW HAVEN CT
06511-6624
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-5682
  • Fax: 203-785-3419
Mailing address:
  • Phone: 203-785-7998
  • Fax: 203-785-6414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number040378
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number040378
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: