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General NPI Number Information
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NPI Number | 1285759498
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Entity Type | Organization
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Legal Business Name | BURNETT HEALTHCARE
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 05/09/2008
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Provider Practice Location Address
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Address Line | 11 W SPRING ST
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5438
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Country | US
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Telephone | 716-565-3605
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Fax | 716-565-3609
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Provider Business Mailing Address
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Address Line | 11 W SPRING ST
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5438
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Country | US
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Telephone | 716-565-3605
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Fax | 716-565-3609
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MARGARET LAW
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Credential |
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Telephone | 716-656-0078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 223801
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 117348
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License Number State | NY
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