Individual
CONNIE S BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 NOYES ST, UTICA, NY 13502-3854
(315) 738-3800
(315) 738-3080
Mailing address
1400 NOYES ST, UTICA, NY 13502-3854
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
340124-1
NY
Other
Enumeration date
06/27/2018
Last updated
06/27/2018
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