1841298932 NPI number — DR. ADRIA BURROWS MD

Table of content: DR. ADRIA BURROWS MD (NPI 1841298932)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841298932 NPI number — DR. ADRIA BURROWS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BURROWS
Provider First Name:
ADRIA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BURROWS
Provider Other First Name:
ADRIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1841298932
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50 LEXINGTON AVE
Provider Second Line Business Mailing Address:
STOREFRONT 1
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10010-2935
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-477-4250
Provider Business Mailing Address Fax Number:
212-477-1007

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 LEXINGTON AVE
Provider Second Line Business Practice Location Address:
STOREFRONT 1
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10010-2935
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-477-4250
Provider Business Practice Location Address Fax Number:
212-477-1007
Provider Enumeration Date:
07/12/2005

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: 174400000X , with the licence number:  163544 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: 163544 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01024780 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".