Provider Demographics
NPI:1316919004
Name:KAPUSUZ, TOLGA (MD)
Entity type:Individual
Prefix:DR
First Name:TOLGA
Middle Name:
Last Name:KAPUSUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 DURHAM AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-2555
Mailing Address - Country:US
Mailing Address - Phone:732-338-0228
Mailing Address - Fax:908-941-5963
Practice Address - Street 1:285 DURHAM AVE STE 1A
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-2555
Practice Address - Country:US
Practice Address - Phone:732-338-0228
Practice Address - Fax:908-941-5963
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225264-1207L00000X
NY225264208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02374252Medicaid
NYA400053358Medicare PIN
NY02374252Medicaid