Individual
JAIME VANDERBURGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 GUSTAVE L LEVY PL, NEW YORK, NY 10029-6504
(212) 241-6500
Mailing address
558 FULTON ST APT 1209, BROOKLYN, NY 11217-4362
(774) 270-0755
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
12/08/2022
Last updated
12/08/2022
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