Individual
MATTHEW J BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6620 FLY ROAD, STE 200, EAST SYRACUSE, NY 13057
(315) 464-4472
Mailing address
6620 FLY ROAD, STE 200, EAST SYRACUSE, NY 13057
(315) 464-4472
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
009606
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02720189
—
NY
Enumeration date
06/16/2005
Last updated
11/30/2009
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