Provider Demographics
NPI:1245329861
Name:BURDEN, AMY R (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:R
Last Name:BURDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:R
Other - Last Name:BURDEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST STE SW200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER ANESTHESIA ASSOCIATES
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD421093207L00000X
NJMA076081207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3722345OtherAETNA
NJ37962OtherUNIVERSITY HEALTH PLAN
NJ010006991OtherAMERICHOICE
NJ2565753OtherUNITED HEALTHCARE
NJ2236110000OtherAMERIHEALTH/KEYTSONE/IBC
NJ37962OtherUNIVERSITY HEALTH PLAN
H90982Medicare UPIN
NJ071944 DLFMedicare PIN