Provider Demographics
NPI:1245314046
Name:BURAK, DAVID B (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:BURAK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:808 SEVEN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-7942
Mailing Address - Country:US
Mailing Address - Phone:570-422-1446
Mailing Address - Fax:570-422-1447
Practice Address - Street 1:808 SEVEN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-7942
Practice Address - Country:US
Practice Address - Phone:570-422-1446
Practice Address - Fax:570-422-1447
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC 003211-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA509700OtherBC/BS
PA001126320OtherDEPT. OF PUBLIC WELFARE
PA0518833OtherAETNA
PA1024761OtherUNITED HEALTHCARE
PAP674957OtherOXFORD
PAP674957OtherOXFORD