Provider Demographics
NPI:1376968388
Name:BURO, JOHN (CADC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:BURO
Suffix:
Gender:M
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 FOREST AVE STE 14
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-2037
Mailing Address - Country:US
Mailing Address - Phone:774-269-4700
Mailing Address - Fax:
Practice Address - Street 1:19 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2521
Practice Address - Country:US
Practice Address - Phone:774-269-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)