Provider Demographics
NPI:1750344677
Name:BURN SURGEONS OF SAINT BARNABAS, LLP
Entity type:Organization
Organization Name:BURN SURGEONS OF SAINT BARNABAS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON /PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:PETRONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-322-5924
Mailing Address - Street 1:94 OLD SHORT HILLS RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5672
Mailing Address - Country:US
Mailing Address - Phone:973-322-5924
Mailing Address - Fax:973-322-5447
Practice Address - Street 1:94 OLD SHORT HILLS RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-5924
Practice Address - Fax:973-322-5447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3330401Medicaid
NJBU527309Medicare ID - Type Unspecified