Healthcare Provider Details

I. General information

NPI: 1700887395
Provider Name (Legal Business Name): JOSEF J BURTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date: 03/24/2006
Reactivation Date: 03/24/2006

III. Provider practice location address

41 S MAIN ST
NEW MILFORD CT
06776-3507
US

IV. Provider business mailing address

41 S MAIN ST
NEW MILFORD CT
06776-3507
US

V. Phone/Fax

Practice location:
  • Phone: 860-355-4113
  • Fax: 860-350-4271
Mailing address:
  • Phone: 860-355-4113
  • Fax: 860-350-4271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number020123
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: