Healthcare Provider Details

I. General information

NPI: 1003856063
Provider Name (Legal Business Name): MINA OZA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 01/19/2021
Certification Date: 01/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 NORTH ST STE 201
WHITE PLAINS NY
10605-2232
US

IV. Provider business mailing address

311 NORTH ST STE 201
WHITE PLAINS NY
10605-2232
US

V. Phone/Fax

Practice location:
  • Phone: 914-639-3100
  • Fax: 914-639-3101
Mailing address:
  • Phone: 914-639-3100
  • Fax: 914-639-3101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME0055464
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: