Provider Demographics
NPI:1912407735
Name:BURLINSON, BEN
Entity Type:Individual
Prefix:
First Name:BEN
Middle Name:
Last Name:BURLINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 GARDEN OF THE GODS RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-4218
Mailing Address - Country:US
Mailing Address - Phone:719-571-9590
Mailing Address - Fax:
Practice Address - Street 1:402 GARDEN OF THE GODS RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-4218
Practice Address - Country:US
Practice Address - Phone:719-571-9590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician