Provider Demographics
NPI:1306123716
Name:METIN KOLUKSUZ, M.D.P.C.
Entity type:Organization
Organization Name:METIN KOLUKSUZ, M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:METIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLUKSUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-370-2258
Mailing Address - Street 1:1519 MCCLELLAN ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-5126
Mailing Address - Country:US
Mailing Address - Phone:518-370-2258
Mailing Address - Fax:
Practice Address - Street 1:600 MCCLELLAN ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12304-1009
Practice Address - Country:US
Practice Address - Phone:518-347-5442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD75390Medicare UPIN