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Individual

MR. DAVID M BURGESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
3375 PARK AVE, WANTAGH, NY 11793-3733
(516) 781-1911
(516) 781-1173
Mailing address
3375 PARK AVE, WANTAGH, NY 11793-3733
(516) 781-1911
(516) 781-1173

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
070074-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03003069
NY
Enumeration date
06/22/2010
Last updated
06/22/2010
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