Provider Demographics
NPI:1497959662
Name:BURLINGTON MEDICAL, LTD
Entity Type:Organization
Organization Name:BURLINGTON MEDICAL, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AISTE
Authorized Official - Middle Name:
Authorized Official - Last Name:NORBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-404-1721
Mailing Address - Street 1:258 SPIELMAN HWY
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06013-1723
Mailing Address - Country:US
Mailing Address - Phone:860-404-1721
Mailing Address - Fax:860-404-0421
Practice Address - Street 1:258 SPIELMAN HWY
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06013-1723
Practice Address - Country:US
Practice Address - Phone:860-404-1721
Practice Address - Fax:860-404-0421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT039384207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty