MALLORY ENG BURGER MS CPNP NPI 1104116763

NPI Information

  • NPI: 1104116763
  • Provider Name: MALLORY ENG BURGER, MS, CPNP
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • Address: 728 N MAIN ST
    NEW SQUARE, NY
    ZIP 10977
  • Phone: (845) 354-9033

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NPI Details

Mallory Eng Burger, MS, CPNP is a pediatrics nurse practitioner in New Square, NY. Mallory Eng Burger, MS, CPNP NPI is 1104116763. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

728 N MAIN ST
NEW SQUARE, NY
ZIP 10977-916
Phone: (845) 354-9033

The enumeration date for this NPI number is 4/15/2011 and was last updated on 10/12/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatricsR195051MARYLANDNo
2163W00000XRegistered NurseR195051MARYLANDNo
3163W00000XRegistered Nurse617014NEW YORKNo
4363LP0200XNurse PractitionerPediatrics382293NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1119591300MEDICAIDMARYLAND
2211876MEDICARE OSCAR/CERTIFICATION
3S118MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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