Provider Demographics
NPI:1447792791
Name:BURGOS, AMERICA
Entity Type:Individual
Prefix:
First Name:AMERICA
Middle Name:
Last Name:BURGOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1079 KELLY ST
Mailing Address - Street 2:14
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-2852
Mailing Address - Country:US
Mailing Address - Phone:646-260-0806
Mailing Address - Fax:
Practice Address - Street 1:1079 KELLY ST
Practice Address - Street 2:14
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-2852
Practice Address - Country:US
Practice Address - Phone:646-260-0806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst