Individual
OLGA Y BURBANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16428 ODONNELL RD, JAMAICA, NY 11433-3936
(929) 354-4114
Mailing address
16428 ODONNELL RD, JAMAICA, NY 11433-3936
(929) 354-4114
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
737722726
NY
Other
Enumeration date
01/12/2020
Last updated
01/12/2020
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