Provider Demographics
NPI:1447951207
Name:AVDIC, BELMIN
Entity type:Individual
Prefix:
First Name:BELMIN
Middle Name:
Last Name:AVDIC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 BELKNAP ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-1515
Mailing Address - Country:US
Mailing Address - Phone:315-749-8599
Mailing Address - Fax:
Practice Address - Street 1:39 BELKNAP ST APT 2
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-1515
Practice Address - Country:US
Practice Address - Phone:315-749-8599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician