Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 25MB09495700 | NJ |
N | 207Q00000X | Family Doctor | 25MB09495700 | NJ |
NPI | 1467691709 |
---|---|
Provider Name | Yumie Nishida Burden |
First Address | Ridgewood, NJ 07450-3199 |
Second Address | Ridgewood, NJ 07450-3199 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2009 |
Last Update Date | 09/09/2018 |