Provider Demographics
NPI:1184861825
Name:AYDINOGLU, ONUR (DOM)
Entity Type:Individual
Prefix:DR
First Name:ONUR
Middle Name:
Last Name:AYDINOGLU
Suffix:
Gender:M
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12900 KACHINA PL NE
Mailing Address - Street 2:UNIT A
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-3702
Mailing Address - Country:US
Mailing Address - Phone:206-245-6059
Mailing Address - Fax:
Practice Address - Street 1:10900 MENAUL BLVD NE
Practice Address - Street 2:SUITE F
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2455
Practice Address - Country:US
Practice Address - Phone:206-245-6059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM980171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist