Provider Demographics
NPI:1669584306
Name:BURKHART-SMITH, COLLEEN ELIZABETH (PA)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:ELIZABETH
Last Name:BURKHART-SMITH
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:200 HYGEIA DRIVE
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:610-595-6586
Mailing Address - Fax:610-595-6787
Practice Address - Street 1:4755 OGLETOWN STANTON RD
Practice Address - Street 2:SUITE 5A43
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-623-0188
Practice Address - Fax:610-595-6787
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2017-03-01
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Provider Licenses
StateLicense IDTaxonomies
NY009451-1363A00000X
PAMA054317363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant