1437458700 NPI number — DR. EVE HELEN BURKHARDT PHD

Table of content: DR. EVE HELEN BURKHARDT PHD (NPI 1437458700)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437458700 NPI number — DR. EVE HELEN BURKHARDT PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BURKHARDT
Provider First Name:
EVE
Provider Middle Name:
HELEN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LAZAR
Provider Other First Name:
EVE
Provider Other Middle Name:
HELEN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437458700
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
403 RUSSELL AVE
Provider Second Line Business Mailing Address:
5G
Provider Business Mailing Address City Name:
GAITHERSBURG
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20877-2819
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-216-5837
Provider Business Mailing Address Fax Number:
301-216-5834

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
403 RUSSELL AVE
Provider Second Line Business Practice Location Address:
5G
Provider Business Practice Location Address City Name:
GAITHERSBURG
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20877-2819
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-216-5837
Provider Business Practice Location Address Fax Number:
301-216-5834
Provider Enumeration Date:
03/25/2011

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: 103TC0700X , with the licence number:  003787-1 , 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)