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General NPI Number Information
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NPI Number | 1679551758
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Entity Type | Individual
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Provider Name | FLOYD M. BURGHER JR. PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/09/2006
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Last Update Date | 07/08/2016
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Provider Practice Location Address
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Address Line | 40 HURLEY AVE SUITE 4
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City | KINGSTON
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State | NY
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Zip | 12401-3739
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Country | US
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Telephone | 845-338-5600
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Fax | 845-338-3058
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Provider Business Mailing Address
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Address Line | 7 LONG POND RD
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City | SAUGERTIES
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State | NY
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Zip | 12477-4421
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Country | US
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Telephone | 845-246-5773
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Fax | 845-246-6774
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 002673
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License Number State | NY
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