Provider Demographics
NPI:1326226598
Name:BURNS, JOANNE
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 AVIATION RD
Mailing Address - Street 2:SUITE 1 S- TARGET T-1830
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-1814
Mailing Address - Country:US
Mailing Address - Phone:518-792-7583
Mailing Address - Fax:518-792-7583
Practice Address - Street 1:578 AVIATION RD
Practice Address - Street 2:SUITE 1 S- TARGET T-1830
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-1814
Practice Address - Country:US
Practice Address - Phone:518-792-7583
Practice Address - Fax:518-792-7583
Is Sole Proprietor?:No
Enumeration Date:2008-02-09
Last Update Date:2008-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0451981835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY045198Medicaid