Healthcare Provider Details

I. General information

NPI: 1982791505
Provider Name (Legal Business Name): OZ HARMANLI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 03/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HOWARD AVE 3RD FLOOR
NEW HAVEN CT
06519-1369
US

IV. Provider business mailing address

310 CEDAR STREET PO BOX 208063
NEW HAVEN CT
06520-8063
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-6927
  • Fax: 203-785-2909
Mailing address:
  • Phone: 203-785-6927
  • Fax: 203-785-2909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number56021
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: