MEDICARE: CAN BULUCU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	228855	MA

General Provider Information

NPI Number	:	1942309869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAN BULUCU M.D.

Provider Business Mailing Address
First Line	:	32A WORTHEN RD
Second Line	:	APT3
City	:	LEXINGTON
State	:	MA
Zip	:	02421-4815
Country	:	US
Telephone Number	:	781-786-1739
Fax Number	:

Provider Business Practice Location Address
First Line	:	76 BEDFORD ST
Second Line	:	STE 26
City	:	LEXINGTON
State	:	MA
Zip	:	02420-4641
Country	:	US
Telephone Number	:	978-556-6261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	03/30/2017

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