Provider Demographics
NPI:1407847486
Name:BURNS, EMILY A (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:A
Last Name:BURNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3906 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1108
Mailing Address - Country:US
Mailing Address - Phone:856-596-1600
Mailing Address - Fax:
Practice Address - Street 1:3906 CHURCH RD
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1108
Practice Address - Country:US
Practice Address - Phone:856-596-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11265207Q00000X
NJ25MA11079200207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
990015541OtherRR MEDICARE PIN
NH544992OtherCIGNA PIN
NH30201483Medicaid
NH011265OtherTUFTS PIN
NH01YP03153NH01OtherANTHEM ACES PIN
NH2575709OtherAETNA PIN
NHH03709OtherANTHEM REFERRING UPIN
NH0140944OtherUHC PIN
NHNH2109OtherHPHC PIN
990015541OtherRR MEDICARE PIN
NH30201483Medicaid