Provider Demographics
NPI:1326399122
Name:JOHN BURGER MD PA
Entity Type:Organization
Organization Name:JOHN BURGER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-321-0616
Mailing Address - Street 1:113 BUCHANAN RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3672
Mailing Address - Country:US
Mailing Address - Phone:732-321-0616
Mailing Address - Fax:917-591-4521
Practice Address - Street 1:15 PROSPECT LN
Practice Address - Street 2:SUITE 1E
Practice Address - City:COLONIA
Practice Address - State:NJ
Practice Address - Zip Code:07067-3010
Practice Address - Country:US
Practice Address - Phone:732-321-0616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-20
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB34763207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty