Provider Demographics
NPI:1942462361
Name:KERISLI, BILGIN (DC)
Entity Type:Individual
Prefix:
First Name:BILGIN
Middle Name:
Last Name:KERISLI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BAY 26TH ST
Mailing Address - Street 2:#2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-3905
Mailing Address - Country:US
Mailing Address - Phone:716-316-6158
Mailing Address - Fax:
Practice Address - Street 1:1000 US HIGHWAY 9 N STE 202
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-1200
Practice Address - Country:US
Practice Address - Phone:718-419-0754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011618111N00000X
NJ38MC00747900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor