MEDICARE: MS. AYSE ZUHAL ERTAMAY PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant
2	363AM0700X	Medical Physician Assistant
3	363A00000X	Physician Assistant	004531-1	NY

General Provider Information

NPI Number	:	1285821892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AYSE ZUHAL ERTAMAY PA-C

Provider Business Mailing Address
First Line	:	660 WHITE PLAINS RD FL ENTA4
Second Line	:
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-5139
Country	:	US
Telephone Number	:	914-333-5801
Fax Number	:

Provider Business Practice Location Address
First Line	:	7831 37TH AVE
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-6641
Country	:	US
Telephone Number	:	718-424-0061
Fax Number	:	718-424-0045

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2007
Last Update Date	:	06/23/2022

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