Burke, Jeremy Gordon
Burke, Jeremy Gordon is an individual health care provider with primary practice located at 326 Washington St Department Of Anesthesiology, Norwich CT 06360-2740. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Burke, Jeremy Gordon can be contacted via phone (860) 889-8331.Contact Information
Primary practice address
326 Washington St Department Of Anesthesiology
Norwich CT 06360-2740
Phone: (860) 889-8331
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 051523 | Connecticut |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 51523 | Connecticut |
Profile Details
| NPI number | 1073662482 |
|---|---|
| LBN Legal business name | Burke, Jeremy Gordon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2007 |
| Last updated | Jan 31st, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073662482 | NPPES |
| Connecticut | MEDICAID | 1073662482 |
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