Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1083803613 |
---|---|
Provider Name | Abraham Avi Burstein |
First Address | Brooklyn, NY 11210-5111 |
Second Address | Brooklyn, NY 11229-1805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2007 |
Last Update Date | 19/10/2007 |