Healthcare Provider Details

I. General information

NPI: 1326018425
Provider Name (Legal Business Name): TURGUT YETIL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 WILLARD AVE SUITE 2-D
NEWINGTON CT
06111-2373
US

IV. Provider business mailing address

365 WILLARD AVE SUITE 2-D
NEWINGTON CT
06111-2373
US

V. Phone/Fax

Practice location:
  • Phone: 860-665-1571
  • Fax: 860-667-3668
Mailing address:
  • Phone: 860-665-1571
  • Fax: 860-667-3668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036004
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: