Healthcare Provider Details

I. General information

NPI: 1992742704
Provider Name (Legal Business Name): GIDEON BURIAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 TOWN CTR
NEW BRITAIN PA
18901-5182
US

IV. Provider business mailing address

902 TOWN CTR
NEW BRITAIN PA
18901-5182
US

V. Phone/Fax

Practice location:
  • Phone: 215-348-1970
  • Fax:
Mailing address:
  • Phone: 215-348-1970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC004423-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: