=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477900330
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | OZCAN UZUN M.D.,D.O
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/20/2016
-----------------------------------------------------
Last Update Date | 12/13/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 76 LIVINGSTON AVE STE 1
-----------------------------------------------------
City | NEW BRUNSWICK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08901-2575
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-543-0600
-----------------------------------------------------
Fax | 855-854-6422
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1594
-----------------------------------------------------
City | PISCATAWAY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08855-1594
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-763-2264
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine
-----------------------------------------------------
License Number | 25MB10421700
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------