Provider Demographics
NPI:1982959417
Name:BURZYNSKI, RAYMOND FRANK (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:FRANK
Last Name:BURZYNSKI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2903 N DAVIDSON ST
Mailing Address - Street 2:APT. 2045
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-1096
Mailing Address - Country:US
Mailing Address - Phone:989-370-1281
Mailing Address - Fax:
Practice Address - Street 1:3610 MATTHEWS MINT HILL RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-3605
Practice Address - Country:US
Practice Address - Phone:704-708-5701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22693183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist