Provider Demographics
NPI:1407952864
Name:BURNS, LOREN T (MD)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:T
Last Name:BURNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24W KINGS HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033
Mailing Address - Country:US
Mailing Address - Phone:856-795-1341
Mailing Address - Fax:856-795-5034
Practice Address - Street 1:24W KINGS HIGHWAY
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033
Practice Address - Country:US
Practice Address - Phone:856-795-1341
Practice Address - Fax:856-795-5034
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02696600207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD07041Medicare UPIN
NJ520747Medicare PIN