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NPI Code Detail

MEDICARE: CLIFTON BURT PAIN PHYSICIAN, P.C.

MEDICARE: CLIFTON BURT PAIN PHYSICIAN, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician251765-2NY

General Provider Information

NPI Number : 1154653962
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLIFTON BURT PAIN PHYSICIAN, P.C.
Provider Business Mailing Address
First Line : C2 COTTAGE COURT
Second Line :
City : CLIFTON
State : NJ
Zip : 07012
Country : UM
Telephone Number : 973-928-3363
Fax Number : 973-928-3364
Provider Business Practice Location Address
First Line : C2 COTTAGE CT
Second Line :
City : CLIFTON
State : NJ
Zip : 07012-2142
Country : US
Telephone Number : 973-928-3363
Fax Number : 973-928-3364
Authorized Official
Title or Position : OWNER
Name : DR. CLILFTON BURT
Credential : M.D.
Telephone Number : 973-928-3363
Provider Enumeration Date : 02/03/2010
Last Update Date : 05/16/2013

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