Healthcare Provider Details
I. General information
NPI: 1306123716
Provider Name (Legal Business Name): METIN KOLUKSUZ, M.D.P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/14/2011
Last Update Date: 11/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 MCCLELLAN ST
SCHENECTADY NY
12304-1009
US
IV. Provider business mailing address
1519 MCCLELLAN ST
SCHENECTADY NY
12309-5126
US
V. Phone/Fax
- Phone: 518-347-5442
- Fax:
- Phone: 518-370-2258
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
METIN
KOLUKSUZ
Title or Position: DOCTOR
Credential: M.D.
Phone: 518-370-2258