Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 199512 | NY |
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 199512 | NY |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS013500 | PA |
N | 207Q00000X | Family Doctor | 199512 | NY |
N | 207Q00000X | Family Doctor | OS013500 | PA |
N | 207QA0505X | Family Doctor - Adult Medicine | 199512 | NY |
N | 207QA0505X | Family Doctor - Adult Medicine | OS013500 | PA |
N | 207QS0010X | Family Doctor - Sports Medicine | 199512 | NY |
NPI | 1275522401 |
---|---|
Provider Name | Dr. Denise K Burns |
First Address | Syosset, NY 11791-3125 |
Second Address | Syosset, NY 11791-3125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2005 |
Last Update Date | 08/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G40111 | (02) | NY |