Basic Information
Provider Information
NPI: 1639699572
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BURMAN
FirstName: RON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: 853 SUNNYLEA RD
Address2:  
City: LANSDALE
State: PA
PostalCode: 194464228
CountryCode: US
TelephoneNumber: 6102461875
FaxNumber:  
Practice Location
Address1: 146 MARPLE RD
Address2:  
City: BROOMALL
State: PA
PostalCode: 190082040
CountryCode: US
TelephoneNumber: 6103560100
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/21/2017
LastUpdateDate: 06/21/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOC01548PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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