Organization
ARISTIDE BURDUCEA, D.O LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY M. LEGG (CREDENTIALING COORDINATOR)
(347) 584-8903
Entity
Organization
Contact information
Practice address
21925 PECK AVE, QUEENS VILLAGE, NY 11427-1121
(347) 584-8903
Mailing address
21925 PECK AVE, QUEENS VILLAGE, NY 11427-1121
(347) 584-8903
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891959052
INDIVIDUAL NPI NUMBER
NY
Enumeration date
04/23/2019
Last updated
04/23/2019
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