Healthcare Provider Details

I. General information

NPI: 1174229801
Provider Name (Legal Business Name): CAFER IRMAK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2023
Last Update Date: 02/03/2023
Certification Date: 01/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1R NEWBURY ST STE 401
PEABODY MA
01960-3816
US

IV. Provider business mailing address

1R NEWBURY ST STE 401
PEABODY MA
01960-3816
US

V. Phone/Fax

Practice location:
  • Phone: 617-804-2773
  • Fax:
Mailing address:
  • Phone: 617-804-2773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: