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Individual

DR. JOHN PETER BURGHARDT JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1013 OLD TOWN RD, CORAM, NY 11727-1853
(631) 732-2590
(631) 732-2590
Mailing address
1013 OLD TOWN RD, CORAM, NY 11727-1853
(631) 732-2590
(631) 732-2590

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
002467
NY

Other

Enumeration date
08/02/2005
Last updated
12/30/2010
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