MEDICARE: DR. AYSE CICI GOKALTUN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	103TB0200X	Cognitive & Behavioral Psychologist

General Provider Information

NPI Number	:	1326639055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AYSE CICI GOKALTUN

Provider Business Mailing Address
First Line	:	1855 NICOLE DR
Second Line	:
City	:	DRESHER
State	:	PA
Zip	:	19025-1427
Country	:	US
Telephone Number	:	786-301-1935
Fax Number	:

Provider Business Practice Location Address
First Line	:	882 JACKSONVILLE RD
Second Line	:
City	:	IVYLAND
State	:	PA
Zip	:	18974-4807
Country	:	US
Telephone Number	:	215-355-2011
Fax Number	:	215-396-1886

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2021
Last Update Date	:	01/26/2021

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