Healthcare Provider Details

I. General information

NPI: 1851478457
Provider Name (Legal Business Name): ZEYNEP AYSE EBCIOGLU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LIBERTY SQ
NEW BRITAIN CT
06051-2637
US

IV. Provider business mailing address

1 LIBERTY SQ
NEW BRITAIN CT
06051-2637
US

V. Phone/Fax

Practice location:
  • Phone: 860-827-1343
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number235522
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number235522
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: