Provider Demographics
NPI:1841594090
Name:BURICK CENTER FOR HEALTH AND WELLNESS, P.C.
Entity Type:Organization
Organization Name:BURICK CENTER FOR HEALTH AND WELLNESS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:AZIZKHAN
Authorized Official - Last Name:BURICK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-730-9000
Mailing Address - Street 1:2005 TECHNOLOGY PKWY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-9413
Mailing Address - Country:US
Mailing Address - Phone:717-730-9000
Mailing Address - Fax:717-730-6180
Practice Address - Street 1:2005 TECHNOLOGY PKWY
Practice Address - Street 2:SUITE 350
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-9413
Practice Address - Country:US
Practice Address - Phone:717-730-9000
Practice Address - Fax:717-730-6180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008696L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty