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NPI Code Detail

MEDICARE: DR. PETER G BURK M.D.

MEDICARE:  DR. PETER G BURK  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
1207N00000XDermatology Physician116535NY

General Provider Information

NPI Number : 1619075389
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER G BURK M.D.
Provider Business Mailing Address
First Line : 2426 EASTCHESTER RD STE 212
Second Line :
City : BRONX
State : NY
Zip : 10469-5950
Country : US
Telephone Number : 718-865-8733
Fax Number :
Provider Business Practice Location Address
First Line : 267A W 231ST ST
Second Line :
City : BRONX
State : NY
Zip : 10463-3903
Country : US
Telephone Number : 718-432-8282
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 10/30/2019

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Directions to “ DR. PETER G BURK M.D.” Practice Location

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