MEDICARE: DR. PAUL MICHAEL BURKAT M.D., PH.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	257392	NY
2	2084P0800X	Psychiatry Physician	MD448555	PA

General Provider Information

NPI Number	:	1447261474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL MICHAEL BURKAT M.D., PH.D.

Provider Business Mailing Address
First Line	:	ONE MEDICAL CENTER BLVD.
Second Line	:
City	:	CHESTER
State	:	PA
Zip	:	19013-3995
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	ONE MEDICAL CENTER BLVD.
Second Line	:
City	:	CHESTER
State	:	PA
Zip	:	19013-3995
Country	:	US
Telephone Number	:	585-469-1418
Fax Number	:

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	01/31/2014

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