Provider Demographics
NPI:1629438379
Name:KAZAKIS, CIARA (DO)
Entity Type:Individual
Prefix:
First Name:CIARA
Middle Name:
Last Name:KAZAKIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CIARA
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 TSIENNETO RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038
Mailing Address - Country:US
Mailing Address - Phone:603-216-0400
Mailing Address - Fax:603-216-3800
Practice Address - Street 1:6 TSIENNETO RD
Practice Address - Street 2:SUITE 300
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038
Practice Address - Country:US
Practice Address - Phone:603-216-0400
Practice Address - Fax:603-216-3800
Is Sole Proprietor?:No
Enumeration Date:2016-02-23
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299288208M00000X
390200000X
NH21679207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program