Healthcare Provider Details

I. General information

NPI: 1053691873
Provider Name (Legal Business Name): HANDE OMUR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2011
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 SAW MILL RIVER RD
ARDSLEY NY
10502-2157
US

IV. Provider business mailing address

86 CHESTNUT HILL LN
BRIARCLIFF MANOR NY
10510-2636
US

V. Phone/Fax

Practice location:
  • Phone: 845-490-4034
  • Fax:
Mailing address:
  • Phone: 474-009-8073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number279223
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number279223
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: