Provider Demographics
NPI:1821082058
Name:BURSCHTIN, OMAR E (MD)
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:E
Last Name:BURSCHTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:BOX 3000
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6504
Mailing Address - Country:US
Mailing Address - Phone:212-987-3100
Mailing Address - Fax:212-731-5210
Practice Address - Street 1:11 MADISON SQ N
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-1402
Practice Address - Country:US
Practice Address - Phone:212-481-1818
Practice Address - Fax:212-523-0498
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228562207RS0012X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G44628Medicare UPIN
NY58Y0913Medicare ID - Type Unspecified