Provider Demographics
NPI:1164402111
Name:BURGO, ALFRED J (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:J
Last Name:BURGO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:133 CHURCH HILL RD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-3279
Mailing Address - Country:US
Mailing Address - Phone:412-722-1003
Mailing Address - Fax:412-722-1024
Practice Address - Street 1:133 CHURCH HILL RD
Practice Address - Street 2:SUITE 2A
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-3279
Practice Address - Country:US
Practice Address - Phone:412-722-1003
Practice Address - Fax:412-722-1024
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2020-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD042733207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012249200008Medicaid
PA635138R7RMedicare PIN
PAE61151Medicare UPIN