Individual
LINDA BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35 E 8TH AVE, GLOVERSVILLE, NY 12078-2229
(518) 752-9304
Mailing address
35 E 8TH AVE, GLOVERSVILLE, NY 12078-2229
(518) 752-9304
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
295746-1
NY
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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