Provider Demographics
NPI:1679551758
Name:BURGHER, FLOYD M JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:FLOYD
Middle Name:M
Last Name:BURGHER
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7 LONG POND RD
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-4421
Mailing Address - Country:US
Mailing Address - Phone:845-246-5773
Mailing Address - Fax:845-246-6774
Practice Address - Street 1:40 HURLEY AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3739
Practice Address - Country:US
Practice Address - Phone:845-338-5600
Practice Address - Fax:845-338-3058
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002673363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1679551758Medicaid