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General NPI Number Information
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NPI Number | 1851978373
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Entity Type | Individual
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Provider Name | NICHOLAS BURSTEIN DO
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Gender | Male
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Dates
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Enumeration Date | 03/29/2021
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Last Update Date | 09/02/2024
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Provider Practice Location Address
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Address Line | 369 MAIN ST
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City | SPENCER
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State | MA
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Zip | 01562-1900
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Country | US
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Telephone | 88-855-3922
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Fax | 508-885-4883
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Provider Business Mailing Address
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Address Line | PO BOX 415348
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City | BOSTON
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State | MA
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Zip | 02241-5348
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Country | US
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Telephone | 800-225-8885
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Fax | 508-334-1977
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1020292
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License Number State | MA
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