Healthcare Provider Details

I. General information

NPI: 1144208588
Provider Name (Legal Business Name): FEZA S. TUNC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 02/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

579A CRANBURY RD. UNIVERSITY RADIOLOGY GROUP PC
EAST BRUNSWICK NJ
08816
US

IV. Provider business mailing address

579A CRANBURY ROADD UNIVERSITY RADIOLOGY GROUP PC
EAST BRUNSWICK NJ
08816
US

V. Phone/Fax

Practice location:
  • Phone: 732-390-0040
  • Fax: 732-390-1856
Mailing address:
  • Phone: 732-390-0040
  • Fax: 732-390-1856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number25MA07444000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA07444000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: