Provider Demographics
NPI:1518506559
Name:BURNEY, CECIL TERRANCE
Entity Type:Individual
Prefix:
First Name:CECIL
Middle Name:TERRANCE
Last Name:BURNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 PURITAN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48238-1313
Mailing Address - Country:US
Mailing Address - Phone:313-779-4343
Mailing Address - Fax:
Practice Address - Street 1:3800 PURITAN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48238-1313
Practice Address - Country:US
Practice Address - Phone:313-779-4343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-21
Last Update Date:2019-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246R00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Pathology