Provider Demographics
NPI:1699314047
Name:BURZLER, MELISSA G
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:G
Last Name:BURZLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:G
Other - Last Name:GREENSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:5604 SAGE BRUSH TRL
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-2709
Mailing Address - Country:US
Mailing Address - Phone:206-354-7264
Mailing Address - Fax:
Practice Address - Street 1:5 DUNDAS CIR STE B
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1638
Practice Address - Country:US
Practice Address - Phone:336-294-3338
Practice Address - Fax:336-294-6696
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12989225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2081DOtherBCBS NC
NC1699314047Medicaid