Basic Information
| Provider Information | |||||||||
| NPI: | 1386886042 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAG OZBEK | ||||||||
| FirstName: | AYSE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1554 | ||||||||
| Address2: | |||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117900988 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314440650 | ||||||||
| FaxNumber: | 6316384170 | ||||||||
| Practice Location | |||||||||
| Address1: | 26 RESEARCH WAY | ||||||||
| Address2: | |||||||||
| City: | EAST SETAUKET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117333526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314440580 | ||||||||
| FaxNumber: | 6314447502 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2009 | ||||||||
| LastUpdateDate: | 05/12/2015 | ||||||||
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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 | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RR0500X | 267937 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.