Healthcare Provider Details

I. General information

NPI: 1073600052
Provider Name (Legal Business Name): SUSAN BURIAN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 07/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3871 DANBURY RD
BREWSTER NY
10509-5408
US

IV. Provider business mailing address

34 DE CHIARO LN
WILLISTON PARK NY
11596-1008
US

V. Phone/Fax

Practice location:
  • Phone: 845-278-7700
  • Fax: 845-278-7562
Mailing address:
  • Phone: 914-260-0604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberX007517
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: