Provider Demographics
NPI:1053161034
Name:KIYICI, EZGI
Entity type:Individual
Prefix:
First Name:EZGI
Middle Name:
Last Name:KIYICI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 COLUMBUS CIR
Mailing Address - Street 2:
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-1510
Mailing Address - Country:US
Mailing Address - Phone:914-346-0748
Mailing Address - Fax:
Practice Address - Street 1:7967 BROADWAY
Practice Address - Street 2:
Practice Address - City:LEMON GROVE
Practice Address - State:CA
Practice Address - Zip Code:91945-1809
Practice Address - Country:US
Practice Address - Phone:619-741-3045
Practice Address - Fax:619-741-2752
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program