Healthcare Provider Details

I. General information

NPI: 1386615243
Provider Name (Legal Business Name): STEVEN PAUL OUZOUNIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 12/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 W MONTAUK HWY SUITE 3
HAMPTON BAYS NY
11946-3551
US

IV. Provider business mailing address

185 OLD COUNTRY RD SUITE 2
RIVERHEAD NY
11901-2121
US

V. Phone/Fax

Practice location:
  • Phone: 631-728-0393
  • Fax: 631-728-0394
Mailing address:
  • Phone: 631-298-4479
  • Fax: 631-591-3047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number216059
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number216059
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: