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General NPI Number Information
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NPI Number | 1972788214
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Entity Type | Individual
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Provider Name | MARK JEFFREY BURSTEIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/06/2008
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Last Update Date | 12/04/2008
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Provider Practice Location Address
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Address Line | 400 MIDDLETOWN BLVD SUITE 100
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City | LANGHORNE
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State | PA
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Zip | 19047-1819
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Country | US
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Telephone | 215-757-7300
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Fax | 215-750-7111
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Provider Business Mailing Address
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Address Line | 400 MIDDLETOWN BLVD SUITE 100
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City | LANGHORNE
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State | PA
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Zip | 19047-1819
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Country | US
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Telephone | 215-757-7300
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Fax | 215-750-7111
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD433358
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 25MA08362800
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License Number State | NJ
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