Healthcare Provider Details

I. General information

NPI: 1275769549
Provider Name (Legal Business Name): ISIS BURGOS-CHAPMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ISIS BURGOS

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 EDISON RD
ORANGE CT
06477-3602
US

IV. Provider business mailing address

200 EDISON RD
ORANGE CT
06477-3602
US

V. Phone/Fax

Practice location:
  • Phone: 959-929-9998
  • Fax:
Mailing address:
  • Phone: 959-929-9998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number51911
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: