Provider Demographics
NPI:1427046515
Name:BURSTINER, ANDREW S (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:S
Last Name:BURSTINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BETHANY RD
Mailing Address - Street 2:BUILDING 5;SUITE 65
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1663
Mailing Address - Country:US
Mailing Address - Phone:732-264-0700
Mailing Address - Fax:732-264-1414
Practice Address - Street 1:1 BETHANY RD
Practice Address - Street 2:BUILDING 5;SUITE 65
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1663
Practice Address - Country:US
Practice Address - Phone:732-264-0700
Practice Address - Fax:732-264-1414
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA57897208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5239702Medicaid
NJ5239702Medicaid