Provider Demographics
NPI:1821692344
Name:AVCIOGLU, CARMEN IVETTE
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:IVETTE
Last Name:AVCIOGLU
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 1:8 TIFFANY LN
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3317
Mailing Address - Country:US
Mailing Address - Phone:708-724-9996
Mailing Address - Fax:
Practice Address - Street 1:220 MAPLE ST
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:MA
Practice Address - Zip Code:01949-2265
Practice Address - Country:US
Practice Address - Phone:978-774-9996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20559183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty