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NPI 1518578483

NPI 1518578483 : CAROLINE ELIZABETH BUREK MS, LCAT, BC-DMT : BROOKLYN, NY

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General NPI Number Information
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    NPI Number           |    1518578483
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    Entity Type          |    Individual 
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    Provider Name        |    CAROLINE ELIZABETH BUREK MS, LCAT, BC-DMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/13/2020
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    Last Update Date     |    08/13/2020
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Provider Practice Location Address
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    Address Line         |    451 CLARKSON AVE 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11203-2054
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    Country              |    US
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    Telephone            |    609-313-5789
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    183 PARK AVE APT 3 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11205-2308
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    Country              |    US
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    Telephone            |    609-313-5789
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225600000X
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    Taxonomy Name        |    Dance Therapist
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    License Number       |    002288
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    License Number State |    NY
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