MEDICARE: OLCAY CUBUKCU-DIMOPULO MD

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	214880	NY

General Provider Information

NPI Number	:	1841302882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLCAY CUBUKCU-DIMOPULO MD

Provider Business Mailing Address
First Line	:	1024 NORTH AVE
Second Line	:
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10804-3612
Country	:	US
Telephone Number	:	914-637-4646
Fax Number	:	914-637-4646

Provider Business Practice Location Address
First Line	:	1024 NORTH AVE
Second Line	:
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10804-3612
Country	:	US
Telephone Number	:	914-637-4646
Fax Number	:	914-637-4646

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	08/24/2010

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