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Individual

ALISA M BURDISH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
229 LAUREL RD, E NORTHPORT, NY 11731-1118
(631) 659-3337
Mailing address
16 GARFIELD PL, LINDENHURST, NY 11757-5921

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1338638191
NY
252Y00000X
Early Intervention Provider Agency
1339219191
NY

Other

Enumeration date
08/21/2019
Last updated
08/21/2019
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