Healthcare Provider Details

I. General information

NPI: 1528097151
Provider Name (Legal Business Name): GAIL E BURGEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 EAST MOUNTAIN BLVD
WILKES BARRE PA
18702-7906
US

IV. Provider business mailing address

4051 FREEMANSBURG AVENUE
EASTON PA
18045
US

V. Phone/Fax

Practice location:
  • Phone: 570-808-7916
  • Fax: 570-808-6006
Mailing address:
  • Phone: 610-559-7474
  • Fax: 610-559-9276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD045713L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: