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General NPI Number Information
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NPI Number | 1326399122
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Entity Type | Organization
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Legal Business Name | JOHN BURGER MD PA
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Dates
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Enumeration Date | 09/20/2012
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Last Update Date | 09/28/2012
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Provider Practice Location Address
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Address Line | 15 PROSPECT LN SUITE 1E
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City | COLONIA
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State | NJ
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Zip | 07067-3010
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Country | US
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Telephone | 732-321-0616
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Fax |
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Provider Business Mailing Address
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Address Line | 113 BUCHANAN RD
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City | EDISON
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State | NJ
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Zip | 08820-3672
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Country | US
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Telephone | 732-321-0616
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Fax | 917-591-4521
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. JOHN BURGER
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Credential | D.O.
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Telephone | 732-321-0616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MB34763
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License Number State | NJ
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