Provider Demographics
NPI:1922688860
Name:BURDZY, ANNA MARIA (PA-C)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIA
Last Name:BURDZY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:WALLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07057-1260
Mailing Address - Country:US
Mailing Address - Phone:862-215-2127
Mailing Address - Fax:
Practice Address - Street 1:37 UNION BLVD
Practice Address - Street 2:
Practice Address - City:WALLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07057-1260
Practice Address - Country:US
Practice Address - Phone:862-215-2127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00614600363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant