Individual
TAKIYA CHANISE BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 5TH AVE, NEW YORK, NY 10029-3119
(212) 426-3400
Mailing address
100 CASALS PL, BRONX, NY 10475-3002
(718) 916-4421
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
715032
NY
Other
Enumeration date
01/03/2018
Last updated
01/03/2018
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