Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 013033-01 | NY |
NPI | 1336714864 |
---|---|
Provider Name | Denise Angela Burns |
First Address | Huntington, NY 11743-2322 |
Second Address | Huntington, NY 11743-2322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2021 |
Last Update Date | 26/05/2021 |