Healthcare Provider Details

I. General information

NPI: 1255385233
Provider Name (Legal Business Name): VEDAT OBUZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 10/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 S BROAD ST
TRENTON NJ
08611-1819
US

IV. Provider business mailing address

292 MELROSE AVE
MERION STATION PA
19066-1716
US

V. Phone/Fax

Practice location:
  • Phone: 609-392-6950
  • Fax: 609-392-6739
Mailing address:
  • Phone: 609-937-2297
  • Fax: 610-819-0222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA63577
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMA63577
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: