Healthcare Provider Details

I. General information

NPI: 1750344677
Provider Name (Legal Business Name): BURN SURGEONS OF SAINT BARNABAS, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 OLD SHORT HILLS RD
LIVINGSTON NJ
07039-5672
US

IV. Provider business mailing address

94 OLD SHORT HILLS RD
LIVINGSTON NJ
07039-5672
US

V. Phone/Fax

Practice location:
  • Phone: 973-322-5924
  • Fax: 973-322-5447
Mailing address:
  • Phone: 973-322-5924
  • Fax: 973-322-5447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SYLVIA JEAN PETRONE
Title or Position: SURGEON /PARTNER
Credential: MD
Phone: 973-322-5924