Provider Demographics
NPI:1528064680
Name:BURNS, PAUL C (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:C
Last Name:BURNS
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 1:1815 S CLINTON AVE STE 620
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5723
Mailing Address - Country:US
Mailing Address - Phone:585-319-5354
Mailing Address - Fax:833-450-5339
Practice Address - Street 1:1815 S CLINTON AVE STE 620
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5723
Practice Address - Country:US
Practice Address - Phone:585-319-5354
Practice Address - Fax:833-450-5339
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209941207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G93277Medicare UPIN
BB5032Medicare PIN