Provider Demographics
NPI:1992063770
Name:BURZINSKI, KATHRYN E (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:E
Last Name:BURZINSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 KNAPP AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-0377
Mailing Address - Country:US
Mailing Address - Phone:845-283-3923
Mailing Address - Fax:
Practice Address - Street 1:15 KNAPP AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-0377
Practice Address - Country:US
Practice Address - Phone:845-283-3923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4197332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG56179Medicare UPIN