Basic Information
Provider Information
NPI: 1154440758
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALTUN
FirstName: ZEYNEP
MiddleName: FATMA
NamePrefix: DR.
NameSuffix:  
Credential: M.D., PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 10TH AVE
Address2:  
City: NEW YORK
State: NY
PostalCode: 100191147
CountryCode: US
TelephoneNumber: 2125234000
FaxNumber:  
Practice Location
Address1: 1ST AVENUE, 27TH STREET
Address2: C BUILDING, ROOM 216C
City: NEW YORK
State: NY
PostalCode: 100162401
CountryCode: US
TelephoneNumber: 2125628912
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/28/2007
LastUpdateDate: 12/21/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/21/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X243068NYY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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