Provider Demographics
NPI:1619516754
Name:DEMIROGLU, BEYZANUR
Entity type:Individual
Prefix:
First Name:BEYZANUR
Middle Name:
Last Name:DEMIROGLU
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 1:118 LA BONNE VIE DR APT C
Mailing Address - Street 2:
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-4395
Mailing Address - Country:US
Mailing Address - Phone:631-576-5288
Mailing Address - Fax:
Practice Address - Street 1:118 LA BONNE VIE DR APT C
Practice Address - Street 2:
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-4395
Practice Address - Country:US
Practice Address - Phone:631-576-5288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY328990164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse