1285617027 NPI number — DR. LERZAN S. KIZILAY MD

Table of content: DR. LERZAN S. KIZILAY MD (NPI 1285617027)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285617027 NPI number — DR. LERZAN S. KIZILAY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KIZILAY
Provider First Name:
LERZAN
Provider Middle Name:
S.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285617027
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 ANGIER CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUBURNDALE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02466-2901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-916-1069
Provider Business Mailing Address Fax Number:
617-234-7981

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
YOUVILLE HOSPITAL
Provider Second Line Business Practice Location Address:
1575 CAMBRIDGE ST
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02138-4398
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-876-4344
Provider Business Practice Location Address Fax Number:
617-234-7981
Provider Enumeration Date:
11/25/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  79533 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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