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General NPI Number Information
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NPI Number | 1861575425
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Entity Type | Organization
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Legal Business Name | BURGESS PHARMACY, INC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 56 BROAD ST
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-2500
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Country | US
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Telephone | 973-743-1005
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Fax | 973-743-8850
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Provider Business Mailing Address
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Address Line | 56 BROAD ST
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-2500
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Country | US
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Telephone | 973-743-1005
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Fax | 973-743-8850
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Authorized Official
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Title or Position | OWNER
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Name | MR. DANIEL M ALBIZATI
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Credential | R.PH.
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Telephone | 973-743-1005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28RS00447700 NJ
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License Number State | NJ
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