Individual provider · Type 1 NPI
Mallory Eng Burger, MS, CPNP
Pediatric Nurse Practitioner · New Square, NY
NPI number
1104116763
Active
Practice location
728 N Main St
New Square, NY 10977-8916
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | R195051 (MD) |
| Registered Nurse | 163W00000X | R195051 (MD) |
| Registered Nurse | 163W00000X | 617014 (NY) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | 382293 (NY) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1104116763
Mallory Eng Burger, MS, CPNP's National Provider Identifier is 1104116763, issued on Apr 15, 2011. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in New Square, NY. The record was last updated on Oct 12, 2012.