MEDICARE: BURTON WAISBREN M.D. PROFESSIONAL ASSOCIATION

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	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1487953964
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BURTON WAISBREN M.D. PROFESSIONAL ASSOCIATION

Provider Business Mailing Address
First Line	:	PO BOX 56
Second Line	:
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-0056
Country	:	US
Telephone Number	:	609-465-1593
Fax Number	:	609-465-1595

Provider Business Practice Location Address
First Line	:	212 N MAIN ST
Second Line	:
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-2122
Country	:	US
Telephone Number	:	609-465-1593
Fax Number	:	609-465-1595

Authorized Official
Title or Position	:	OWNER
Name	:	BURTON A WAISBREN
Credential	:	MD
Telephone Number	:	609-465-1593

Provider Enumeration Date	:	03/23/2011
Last Update Date	:	03/23/2011

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