Provider Demographics
NPI:1285617027
Name:KIZILAY, LERZAN S (MD)
Entity type:Individual
Prefix:DR
First Name:LERZAN
Middle Name:S
Last Name:KIZILAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5 ANGIER CIR
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02466-2901
Mailing Address - Country:US
Mailing Address - Phone:617-916-1069
Mailing Address - Fax:617-234-7981
Practice Address - Street 1:YOUVILLE HOSPITAL
Practice Address - Street 2:1575 CAMBRIDGE ST
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4398
Practice Address - Country:US
Practice Address - Phone:617-876-4344
Practice Address - Fax:617-234-7981
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA79533207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F98945Medicare UPIN