Provider Demographics
NPI:1386615243
Name:OUZOUNIAN, STEVEN PAUL (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:PAUL
Last Name:OUZOUNIAN
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 1:185 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2121
Mailing Address - Country:US
Mailing Address - Phone:631-298-4479
Mailing Address - Fax:631-591-3047
Practice Address - Street 1:332 W MONTAUK HWY
Practice Address - Street 2:SUITE 3
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946-3551
Practice Address - Country:US
Practice Address - Phone:631-728-0393
Practice Address - Fax:631-728-0394
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216059174400000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02369602Medicaid
NYH72696Medicare UPIN
NY0305H1Medicare ID - Type Unspecified