Provider Demographics
NPI:1346576394
Name:BURGERT-LON, CHRISTINE ELIZABETH (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ELIZABETH
Last Name:BURGERT-LON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 OGLETOWN STANTON RD STE 4200
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2075
Mailing Address - Country:US
Mailing Address - Phone:302-737-7700
Mailing Address - Fax:302-737-5407
Practice Address - Street 1:4701 OGLETOWN STANTON RD STE 4200
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2075
Practice Address - Country:US
Practice Address - Phone:302-737-7700
Practice Address - Fax:302-737-5407
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0023925207ZC0500X, 207ZP0102X
PAOS016227207ZP0101X
PAOT013051390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program