MEDICARE: BURCU COLOK

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	174400000X	Specialist	1208365	NY

General Provider Information

NPI Number	:	1497110969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BURCU COLOK

Provider Business Mailing Address
First Line	:	1360 OCEAN PKWY
Second Line	:	APT 3A
City	:	BROOKLYN
State	:	NY
Zip	:	11230-5660
Country	:	US
Telephone Number	:	347-221-4481
Fax Number	:

Provider Business Practice Location Address
First Line	:	2748 OCEAN AVE
Second Line	:	4TH FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4708
Country	:	US
Telephone Number	:	646-237-3450
Fax Number	:

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

Provider Enumeration Date	:	12/28/2015
Last Update Date	:	12/28/2015

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Directions to “ BURCU COLOK ” Practice Location

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