Provider Demographics
NPI:1114076916
Name:BURLAT, JAMES EDWARD RUGUIAN (PT)
Entity type:Individual
Prefix:MR
First Name:JAMES EDWARD
Middle Name:RUGUIAN
Last Name:BURLAT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8498 HOMELAWN ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-2153
Mailing Address - Country:US
Mailing Address - Phone:718-297-3797
Mailing Address - Fax:
Practice Address - Street 1:1200 KING ST
Practice Address - Street 2:
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-7000
Practice Address - Country:US
Practice Address - Phone:917-864-7706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0258351225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist