Provider Demographics
NPI:1508486127
Name:BURDZY, ANNE CASTLEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:CASTLEY
Last Name:BURDZY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 SPRING MILL LN
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2655
Mailing Address - Country:US
Mailing Address - Phone:856-887-1590
Mailing Address - Fax:
Practice Address - Street 1:375 N MAIN ST STE B6
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-1475
Practice Address - Country:US
Practice Address - Phone:856-887-1590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018500103T00000X
NJ35SI00608500103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist