Provider Demographics
NPI:1205531480
Name:BURKHARDT, PAIGE (RRA/RPA)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:BURKHARDT
Suffix:
Gender:F
Credentials:RRA/RPA
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:BURKHARDT
Other - Last Name:LAING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:28 THE STRAND
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152-8845
Mailing Address - Country:US
Mailing Address - Phone:717-324-6877
Mailing Address - Fax:
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3676
Practice Address - Country:US
Practice Address - Phone:717-851-2568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
21MD3182243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant