Healthcare Provider Details

I. General information

NPI: 1033562517
Provider Name (Legal Business Name): MICHAEL BURNS PHARM.D., MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2016
Last Update Date: 07/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 TELEGRAPH RD
MIDDLEPORT NY
14105-9638
US

IV. Provider business mailing address

2464 SOUTH AVE
NIAGARA FALLS NY
14305-3120
US

V. Phone/Fax

Practice location:
  • Phone: 716-735-3261
  • Fax:
Mailing address:
  • Phone: 716-957-0087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number061743
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: