Basic Information
| Provider Information | |||||||||
| NPI: | 1225002249 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | OZKAN | ||||||||
| FirstName: | SUSAN | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 360 MATHEWS RD | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6038670152 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 ELLIOT WAY | ||||||||
| Address2: | EMERGENCY MEDICINE SPECIALISTS OF THE ELLIOT | ||||||||
| City: | MANCHESTER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031033547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036632830 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2006 | ||||||||
| LastUpdateDate: | 07/21/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 0322P | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 30330260 | 05 | NH | MEDICAID |