Provider Demographics
NPI:1790029981
Name:KAYA, MERVE
Entity Type:Individual
Prefix:
First Name:MERVE
Middle Name:
Last Name:KAYA
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 1:865 BROADWAY AVE
Mailing Address - Street 2:APT 124B
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-4953
Mailing Address - Country:US
Mailing Address - Phone:631-680-9748
Mailing Address - Fax:
Practice Address - Street 1:865 BROADWAY AVE
Practice Address - Street 2:APT 124B
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-4953
Practice Address - Country:US
Practice Address - Phone:631-680-9748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-12
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6649975-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse