Healthcare Provider Details

I. General information

NPI: 1497775100
Provider Name (Legal Business Name): RONALD LEE BURINSKY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 STATE HIGHWAY 30
BASIN WY
82410-8801
US

IV. Provider business mailing address

35 STATE HIGHWAY 30
BASIN WY
82410-8801
US

V. Phone/Fax

Practice location:
  • Phone: 484-794-1013
  • Fax:
Mailing address:
  • Phone: 484-794-1013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS006243L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number12294A
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: