Provider Demographics
NPI:1073688453
Name:ALLAN BURSTEIN MD PA
Entity Type:Organization
Organization Name:ALLAN BURSTEIN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OFFICER PROFESSIONAL CORPORAT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:BURSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-462-5270
Mailing Address - Street 1:505 STILLWELLS CORNER RD
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728
Mailing Address - Country:US
Mailing Address - Phone:732-462-5270
Mailing Address - Fax:646-672-0446
Practice Address - Street 1:505 STILLWELLS CORNER RD
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728
Practice Address - Country:US
Practice Address - Phone:732-462-5270
Practice Address - Fax:646-672-0446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA028559002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ119285OtherPTAN
NJ144472Medicare PIN