Provider Demographics
NPI:1386784171
Name:BURINESCU, MARTIN L (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:L
Last Name:BURINESCU
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5669 RIVERDALE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-2105
Mailing Address - Country:US
Mailing Address - Phone:718-543-7501
Mailing Address - Fax:718-543-1421
Practice Address - Street 1:5669 RIVERDALE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-2105
Practice Address - Country:US
Practice Address - Phone:718-543-7500
Practice Address - Fax:718-543-1421
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019569333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01038944Medicaid