Provider Demographics
NPI:1831100718
Name:BURDA, JAMES ANDREW (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ANDREW
Last Name:BURDA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CELESTE DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-2832
Mailing Address - Country:US
Mailing Address - Phone:814-255-6781
Mailing Address - Fax:814-255-5716
Practice Address - Street 1:2 CELESTE DR
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-2832
Practice Address - Country:US
Practice Address - Phone:814-255-6781
Practice Address - Fax:814-255-5716
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002445L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA004346Medicare PIN