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General NPI Number Information
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NPI Number | 1457520967
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Entity Type | Organization
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Legal Business Name | PENINA BURNSTEIN MD PLLC
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 04/14/2008
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Provider Practice Location Address
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Address Line | 1318 52ND STREET
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City | BROOKLYN
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State | NY
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Zip | 11219
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Country | US
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Telephone | 718-437-4500
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Fax | 718-871-2052
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Provider Business Mailing Address
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Address Line | PO BOX 190233
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City | BROOKLYN
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State | NY
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Zip | 11219-0233
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Country | US
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Telephone | 718-437-4500
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Fax | 718-504-3817
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Authorized Official
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Title or Position | OWNER
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Name | PENINA BURNSTEIN
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Credential | M.D.
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Telephone | 718-437-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 184158
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License Number State | NY
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