1427376698 NPI number — DR. DENNIS ANDREW BURACHINSKY D.O.

Table of content: DR. DENNIS ANDREW BURACHINSKY D.O. (NPI 1427376698)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427376698 NPI number — DR. DENNIS ANDREW BURACHINSKY D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BURACHINSKY
Provider First Name:
DENNIS
Provider Middle Name:
ANDREW
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427376698
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
660 WHITE PLAINS RD FL 4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TARRYTOWN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10591-5139
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-984-2546
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
245 US HIGHWAY 22
Provider Second Line Business Practice Location Address:
SUITE 300 - ENTA
Provider Business Practice Location Address City Name:
BRIDGEWATER
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08807-2560
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-722-1022
Provider Business Practice Location Address Fax Number:
908-722-2040
Provider Enumeration Date:
05/12/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207YX0905X , with the licence number:  25MB09066600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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