MEDICARE: DR. DMITRIY K. BURMAN M.D.

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
1	208000000X	Pediatrics Physician	MD070833L	PA
2	208000000X	Pediatrics Physician	218036	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275531568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DMITRIY K. BURMAN M.D.

Provider Business Mailing Address
First Line	:	2516 E 28TH ST
Second Line	:	FL 1
City	:	BROOKLYN
State	:	NY
Zip	:	11235-2019
Country	:	US
Telephone Number	:	905-553-8553
Fax Number	:	905-553-8558

Provider Business Practice Location Address
First Line	:	2516 E 28TH ST
Second Line	:	FL 1
City	:	BROOKLYN
State	:	NY
Zip	:	11235-2019
Country	:	US
Telephone Number	:	905-553-8553
Fax Number	:	905-553-8558

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	04/01/2016

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