Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 007762-1 | NY |
Y | 101YM0800X | Mental Health Counselor | 007762-1 | NY |
N | 103K00000X | Behavior Analyst | 007762-1 | NY |
N | 1041C0700X | Clinical Social Worker | 007762-1 | NY |
N | 156FX1900X | Orthoptist | 007762-1 | NY |
NPI | 1003128661 |
---|---|
Provider Name | Ms. Raya Burstein |
First Address | Flushing, NY 11367-2820 |
Second Address | Flushing, NY 11367-2820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2010 |
Last Update Date | 11/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
$$$$$$$$$ | (02) | NY |