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General NPI Number Information
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NPI Number | 1174717623
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Entity Type | Organization
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Legal Business Name | TWIN FORKS SURGICAL ASSOCIATES, PC
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 02/12/2010
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Provider Practice Location Address
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Address Line | 332 W MONTAUK HWY SUITE 3
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City | HAMPTON BAYS
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State | NY
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Zip | 11946-3551
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Country | US
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Telephone | 631-728-0393
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Fax | 631-728-0394
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Provider Business Mailing Address
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Address Line | 332 W MONTAUK HWY SUITE 3
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City | HAMPTON BAYS
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State | NY
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Zip | 11946-3551
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Country | US
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Telephone | 631-728-0393
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Fax | 631-728-0394
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN P OUZOUNIAN
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Credential | MD
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Telephone | 631-728-9360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 216059
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License Number State | NY
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