Provider Demographics
NPI:1952550386
Name:KZIRIAN, MELANIE SARA (MS)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:SARA
Last Name:KZIRIAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4726 BLAKISTON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19136-1515
Mailing Address - Country:US
Mailing Address - Phone:215-335-7940
Mailing Address - Fax:215-335-7947
Practice Address - Street 1:8020 CASTOR AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-2732
Practice Address - Country:US
Practice Address - Phone:215-722-4111
Practice Address - Fax:215-722-6136
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA00935237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter