Provider Demographics
NPI:1518125764
Name:BURNSTEIN, SHIRA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIRA
Middle Name:
Last Name:BURNSTEIN
Suffix:
Gender:F
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:PO BOX 300703
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-0703
Mailing Address - Country:US
Mailing Address - Phone:718-998-1700
Mailing Address - Fax:718-377-9574
Practice Address - Street 1:2044 OCEAN AVE
Practice Address - Street 2:SUITE A8
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7328
Practice Address - Country:US
Practice Address - Phone:718-998-1700
Practice Address - Fax:718-377-9574
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169174207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY40F491Medicare PIN
NYE45036Medicare UPIN