Provider Demographics
NPI:1639204555
Name:BURGESS HEALTH ASSOCIATES LLC
Entity Type:Organization
Organization Name:BURGESS HEALTH ASSOCIATES LLC
Other - Org Name:HEALTHTRAC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-614-3285
Mailing Address - Street 1:4950 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14225-5550
Mailing Address - Country:US
Mailing Address - Phone:716-614-3260
Mailing Address - Fax:716-614-3282
Practice Address - Street 1:203 CONCORD ST
Practice Address - Street 2:SUITE 319
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-3477
Practice Address - Country:US
Practice Address - Phone:401-724-2280
Practice Address - Fax:401-724-6722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI00408521OtherBLUE CHIP
RI23334-9OtherHEALTHMATE