Provider Demographics
NPI:1699814822
Name:BURCKHARD, JOSHUA MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:MICHAEL
Last Name:BURCKHARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1402
Mailing Address - Country:US
Mailing Address - Phone:845-876-6450
Mailing Address - Fax:
Practice Address - Street 1:13 W MARKET ST
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1402
Practice Address - Country:US
Practice Address - Phone:845-876-6450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011356111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX00181Medicare UPIN