Individual
DERON JAMES-SUUBI BURKHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1442 PINSON ST, FAR ROCKAWAY, NY 11691-3148
(516) 204-8940
Mailing address
1442 PINSON ST, FAR ROCKAWAY, NY 11691-3148
(516) 204-8940
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
033214-01
NY
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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