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General NPI Number Information
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NPI Number | 1073061826
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Entity Type | Organization
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Legal Business Name | G BURBANO
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Dates
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Enumeration Date | 09/21/2016
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Last Update Date | 09/21/2016
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Provider Practice Location Address
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Address Line | 33 WALT WHITMAN RD SUITE 232
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-3640
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Country | US
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Telephone | 513-433-3082
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Fax | 516-433-3089
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Provider Business Mailing Address
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Address Line | 33 WALT WHITMAN RD SUITE 232
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-3640
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Country | US
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Telephone | 513-433-3082
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Fax | 516-433-3089
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. LAWRENCE LIPPERT
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Credential | M.D.
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Telephone | 516-433-3082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 111399-1
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License Number State | NY
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