Provider Demographics
NPI:1033115951
Name:BURNS, DEBRA A (DC)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:A
Last Name:BURNS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PUTNAM
Mailing Address - State:CT
Mailing Address - Zip Code:06260-1906
Mailing Address - Country:US
Mailing Address - Phone:860-928-2292
Mailing Address - Fax:860-928-0537
Practice Address - Street 1:21 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PUTNAM
Practice Address - State:CT
Practice Address - Zip Code:06260-1906
Practice Address - Country:US
Practice Address - Phone:860-928-2292
Practice Address - Fax:860-928-0537
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000728111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD400146058OtherMEDICARE INDIVIDUAL PTAN
CTT06089Medicare UPIN
CT1033115951OtherNPPES