Individual
DAISY C. BURGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
6035 FRESH POND RD, MASPETH, NY 11378-3541
(718) 628-5326
(718) 628-3719
Mailing address
8824 219TH ST, QUEENS VILLAGE, NY 11427-2017
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
026429-1
NY
Other
Enumeration date
10/11/2006
Last updated
10/10/2007
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