Healthcare Provider Details

I. General information

NPI: 1851173470
Provider Name (Legal Business Name): FRANCIS CARLTON BURFORD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 10/18/2023
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1808 3RD AVE
NEW YORK NY
10029-6103
US

IV. Provider business mailing address

1808 3RD AVE
NEW YORK NY
10029-6103
US

V. Phone/Fax

Practice location:
  • Phone: 646-632-3920
  • Fax:
Mailing address:
  • Phone: 646-632-3920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number332780
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: