Provider Demographics
NPI:1386886042
Name:BAG OZBEK, AYSE (MD)
Entity type:Individual
Prefix:
First Name:AYSE
Middle Name:
Last Name:BAG OZBEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1554
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0988
Mailing Address - Country:US
Mailing Address - Phone:631-444-0650
Mailing Address - Fax:631-638-4170
Practice Address - Street 1:26 RESEARCH WAY
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3526
Practice Address - Country:US
Practice Address - Phone:631-444-0580
Practice Address - Fax:631-444-7502
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NY267937207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology