Provider Demographics
NPI:1356034250
Name:TUCCAR BURAK, MERVE (OD)
Entity type:Individual
Prefix:DR
First Name:MERVE
Middle Name:
Last Name:TUCCAR BURAK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 PROVINCE ST APT 1903
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-4138
Mailing Address - Country:US
Mailing Address - Phone:978-942-0413
Mailing Address - Fax:
Practice Address - Street 1:1623 BEACON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-4531
Practice Address - Country:US
Practice Address - Phone:617-739-2707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MAOPT5638152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program