Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 203653 | NY |
N | 111NI0900X | Internist | 203653 | NY |
Y | 207RR0500X | Rheumatology | 203653 | NY |
NPI | 1023022233 |
---|---|
Provider Name | Nathalie D. Burg |
First Address | Elmhurst, NY 11373-1329 |
Second Address | Elmhurst, NY 11373-1329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 22/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02377571 | (05) | NY |
H80445 | (02) | NY |