Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 202279 | NY |
NPI | 1013977123 |
---|---|
Provider Name | Dr. Cheryl B Burack |
First Address | Albany, NY 12209-1718 |
Second Address | Albany, NY 12209-1718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 05/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01642093 | (05) | NY |
G25585 | (02) | NY |