Provider Demographics
NPI:1275531568
Name:BURMAN, DMITRIY K (MD)
Entity Type:Individual
Prefix:DR
First Name:DMITRIY
Middle Name:K
Last Name:BURMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2516 E 28TH ST
Mailing Address - Street 2:FL 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2019
Mailing Address - Country:US
Mailing Address - Phone:905-553-8553
Mailing Address - Fax:905-553-8558
Practice Address - Street 1:2516 E 28TH ST
Practice Address - Street 2:FL 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2019
Practice Address - Country:US
Practice Address - Phone:905-553-8553
Practice Address - Fax:905-553-8558
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070833L208000000X
NY218036208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012749980001Medicaid
PA1012749980001Medicaid
PAH35667Medicare UPIN