Individual
ILENE HEIDI BURACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
230 N BROAD ST, PHILADELPHIA, PA 19102-1121
(215) 762-7000
Mailing address
1661 LARK LN, CHERRY HILL, NJ 08003-3156
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MT188558
PA
Other
Enumeration date
07/22/2008
Last updated
07/22/2008
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