Provider Demographics
NPI:1013394972
Name:BURROWS-ROSENBERG, ANN DAVIS
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:DAVIS
Last Name:BURROWS-ROSENBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:BURROWS-ROS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:195 ADAMS ST
Mailing Address - Street 2:APT 17E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1851
Mailing Address - Country:US
Mailing Address - Phone:718-737-1284
Mailing Address - Fax:
Practice Address - Street 1:195 ADAMS ST
Practice Address - Street 2:APT 1K
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-1851
Practice Address - Country:US
Practice Address - Phone:718-737-1284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021315235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist