Individual
DR. BETH MICHELLE BURGHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5100 W TAFT RD, SUITE 4L, LIVERPOOL, NY 13088-3807
(315) 452-2124
(315) 452-2128
Mailing address
5100 W TAFT RD, SUITE 4L, LIVERPOOL, NY 13088-3807
(315) 452-2124
(315) 452-2128
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
185289
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01413107
—
NY
01
—
61719913
NYS PIN
NY
Enumeration date
02/03/2006
Last updated
06/19/2008
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