Provider Demographics
NPI:1528550365
Name:CAVUSOGLU, CEMRE
Entity Type:Individual
Prefix:
First Name:CEMRE
Middle Name:
Last Name:CAVUSOGLU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-741-8003
Mailing Address - Fax:717-461-7404
Practice Address - Street 1:25 MONUMENT RD STE 140
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5057
Practice Address - Country:US
Practice Address - Phone:717-741-8003
Practice Address - Fax:717-461-7404
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD474630207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine