Provider Demographics
NPI:1578661856
Name:BURNS, TALITHA MARIANA HEDLEY (DO)
Entity Type:Individual
Prefix:DR
First Name:TALITHA
Middle Name:MARIANA HEDLEY
Last Name:BURNS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 SHADYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1718
Mailing Address - Country:US
Mailing Address - Phone:201-953-3941
Mailing Address - Fax:
Practice Address - Street 1:240 SHADYSIDE RD
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1718
Practice Address - Country:US
Practice Address - Phone:201-785-7113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07667600208D00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0119113Medicaid
NJ0119113Medicaid
NJ104654YMOMedicare PIN
NJ104654Medicare PIN