Healthcare Provider Details

I. General information

NPI: 1750459947
Provider Name (Legal Business Name): ANGELA CHRISTINE BUREK LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1238 FRIEDMAN RD
ATTICA NY
14011-9708
US

IV. Provider business mailing address

1238 FRIEDMAN RD
ATTICA NY
14011-9708
US

V. Phone/Fax

Practice location:
  • Phone: 585-591-1375
  • Fax:
Mailing address:
  • Phone: 585-591-1375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number267305-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: