Individual
MR. DERICK A. BURWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.C.
Contact information
Practice address
1241 LAFAYETTE AVE, BRONX, NY 10474-5336
(718) 378-6500
(718) 842-3846
Mailing address
781 E 142ND ST, BRONX, NY 10454-1723
(718) 993-1400
(718) 993-0647
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
41104
NY
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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