Healthcare Provider Details

I. General information

NPI: 1366432593
Provider Name (Legal Business Name): BERIL BAYRAK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 VARNUM AVENUE SUITE 204
LOWELL MA
01854-2109
US

IV. Provider business mailing address

275 VARNUM AVENUE SUITE 204
LOWELL MA
01854-2109
US

V. Phone/Fax

Practice location:
  • Phone: 978-452-1666
  • Fax: 978-452-1780
Mailing address:
  • Phone: 978-452-1666
  • Fax: 978-452-1780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number244095
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: