Organization
BURGESS HEALTH ASSOCIATES, LLC
Active
Other names
HealthTrac
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN ROBINSON (PRESIDENT)
(716) 614-3285
Entity
Organization
Contact information
Practice address
460 SMITH ST, MIDDLETOWN, CT 06457-1594
(860) 632-8000
(860) 632-8008
Mailing address
4950 GENESEE ST, SUITE 180, BUFFALO, NY 14225-5550
(716) 614-3260
(716) 614-3282
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
N/A
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004011417
—
CT
01
—
16-01778
PROVIDER ID EVERCARE
CT
01
—
916152
CONNECTICARE
CT
01
—
CV4958
PROVIDER ID HEALTHNET
CT
01
—
CV6643
PROVIDER ID HEALTHNET
CT
Enumeration date
06/24/2006
Last updated
01/27/2011
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