MEDICARE: PETER BURKART 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	207RH0000X	Hematology (Internal Medicine) Physician	104050	NY

General Provider Information

NPI Number	:	1558357665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER BURKART M.D.

Provider Business Mailing Address
First Line	:	1003 NEW LOUDON RD
Second Line	:
City	:	COHOES
State	:	NY
Zip	:	12047-5003
Country	:	US
Telephone Number	:	518-786-7723
Fax Number	:

Provider Business Practice Location Address
First Line	:	1003 LOUDEN
Second Line	:
City	:	COHOES
State	:	NY
Zip	:	12047-5003
Country	:	US
Telephone Number	:	518-786-7723
Fax Number	:	518-786-7749

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

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	12/03/2009

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