Provider Demographics
NPI:1871783506
Name:BURNS, GERARD JOSEPH II (DO)
Entity type:Individual
Prefix:DR
First Name:GERARD
Middle Name:JOSEPH
Last Name:BURNS
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 405
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-0405
Mailing Address - Country:US
Mailing Address - Phone:856-905-4248
Mailing Address - Fax:
Practice Address - Street 1:402 LIPPINCOTT DR
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-4112
Practice Address - Country:US
Practice Address - Phone:856-782-3300
Practice Address - Fax:856-504-8029
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014766207R00000X
NJ25MB08857200208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA162484Medicare PIN
NJ077356Medicare Oscar/Certification