Provider Demographics
NPI:1508810821
Name:BURNS, DANIEL A (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:A
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 1:2265 MARKET ST STE B
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-4682
Mailing Address - Country:US
Mailing Address - Phone:814-726-1122
Mailing Address - Fax:814-723-2024
Practice Address - Street 1:2265 MARKET ST STE B
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-4682
Practice Address - Country:US
Practice Address - Phone:814-726-1122
Practice Address - Fax:814-723-2024
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185208207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000511692006OtherBC BS WNY
NY01245596Medicaid
NY0707768OtherINDEPENDENT HEALTH
NY00010023102OtherUNIVERA HEALTHCARE
NY000511692002OtherBC BS WNY
E79852Medicare UPIN
NY0707768OtherINDEPENDENT HEALTH