Provider Demographics
NPI:1356420418
Name:HAZNEDAR, MUSTAFA MEHMET (MD)
Entity type:Individual
Prefix:DR
First Name:MUSTAFA
Middle Name:MEHMET
Last Name:HAZNEDAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1879 MADISON AVE
Mailing Address - Street 2:6TH FLR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-2709
Mailing Address - Country:US
Mailing Address - Phone:212-423-4500
Mailing Address - Fax:212-423-1404
Practice Address - Street 1:1879 MADISON AVE
Practice Address - Street 2:6TH FLR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-2709
Practice Address - Country:US
Practice Address - Phone:212-423-4500
Practice Address - Fax:212-423-1404
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2109912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02108469Medicaid
NYPENDINGMedicare UPIN
53M092Medicare PIN