Provider Demographics
NPI:1427033547
Name:OZA, KULIN N (MD)
Entity type:Individual
Prefix:DR
First Name:KULIN
Middle Name:N
Last Name:OZA
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 1:21 FOX ST STE 104
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-4723
Mailing Address - Country:US
Mailing Address - Phone:845-431-2400
Mailing Address - Fax:
Practice Address - Street 1:101 HEALTH CARE DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:IL
Practice Address - Zip Code:62246-1159
Practice Address - Country:US
Practice Address - Phone:618-664-2531
Practice Address - Fax:618-664-2553
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2021-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036144417208600000X
IAMD-44644208600000X
NJ25MA06359300208600000X
NY309520208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7000502Medicaid
NJ7000502Medicaid
NJ868177Medicare ID - Type Unspecified