Provider Demographics
NPI:1508014101
Name:ALTER, BURTON NORMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BURTON
Middle Name:NORMAN
Last Name:ALTER
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 1:38 TUMBLEBROOK LN
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1457
Mailing Address - Country:US
Mailing Address - Phone:860-233-4349
Mailing Address - Fax:
Practice Address - Street 1:38 TUMBLEBROOK LN
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-1457
Practice Address - Country:US
Practice Address - Phone:860-233-4349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT013346208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT013346OtherSTATE OF CT LICENSE NUMBER