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General NPI Number Information
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NPI Number | 1205917663
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Entity Type | Individual
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Provider Name | PHYLLIS MARIE BURGIO D.C.
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Gender | Female
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6161 TRANSIT RD SUITE #7
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City | EAST AMHERST
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State | NY
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Zip | 14051-2606
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Country | US
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Telephone | 716-688-8856
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Fax | 716-688-9323
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Provider Business Mailing Address
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Address Line | 6161 TRANSIT RD SUITE #7
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City | EAST AMHERST
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State | NY
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Zip | 14051-2606
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Country | US
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Telephone | 716-688-8856
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X005436-2
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License Number State | NY
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