Provider Demographics
NPI:1205869237
Name:BURNEY, SIBTE (MD)
Entity type:Individual
Prefix:
First Name:SIBTE
Middle Name:
Last Name:BURNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16 WINDEMERE WAY
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1534
Mailing Address - Country:US
Mailing Address - Phone:516-297-8852
Mailing Address - Fax:718-268-6171
Practice Address - Street 1:8046 KEW GARDENS RD
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-1154
Practice Address - Country:US
Practice Address - Phone:718-268-6171
Practice Address - Fax:718-268-6171
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI84129207RI0200X
NY154963207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01D922Medicare PIN
NY43466Medicare PIN
NYA59902Medicare UPIN