Burgess, Althea Marie

Burgess, Althea Marie is an sole proprietor health care provider with primary practice located at 158 Maida Ave , Deer Park NY 11729. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Burgess, Althea Marie can be contacted via phone (631) 242-0637.

Contact Information

Primary practice address
158 Maida Ave Deer Park NY 11729
Phone: (631) 242-0637
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 204219 New York

Profile Details

NPI number 1942468889
LBN Legal business name Burgess, Althea Marie
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 28th, 2008
Last updated May 28th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942468889 NPPES
New York MEDICAID 02108845

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