Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | X007517 | NY |
NPI | 1073600052 |
---|---|
Provider Name | Dr. Susan Burian |
First Address | Williston Park, NY 11596-1008 |
Second Address | Brewster, NY 10509-5408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2006 |
Last Update Date | 16/07/2012 |