Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 186751 | NY |
NPI | 1023002748 |
---|---|
Provider Name | Paul D Burrows |
First Address | Poughkeepsie, NY 12601-5401 |
Second Address | Poughkeepsie, NY 12601-5401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2005 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01698044 | (05) | NY |
G01510 | (02) | NY |
PB055J0920 | EMPIRE BLUE CROSS BLUE SHIELD (01) | NY |