Healthcare Provider Details

I. General information

NPI: 1215919212
Provider Name (Legal Business Name): CUNEYT ISCAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 03/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 LYMAN ST STE 400
WESTBOROUGH MA
01581-1434
US

IV. Provider business mailing address

16 ROBIN RD
WESTBOROUGH MA
01581-1218
US

V. Phone/Fax

Practice location:
  • Phone: 508-898-0055
  • Fax: 508-898-0035
Mailing address:
  • Phone: 508-864-2607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number215304
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: