Provider Demographics
NPI:1609087535
Name:BURNEY, REUBIN EUGENE (CASAC)
Entity Type:Individual
Prefix:MR
First Name:REUBIN
Middle Name:EUGENE
Last Name:BURNEY
Suffix:
Gender:M
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 FULTON AVE APT 212
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4100
Mailing Address - Country:US
Mailing Address - Phone:516-241-6175
Mailing Address - Fax:
Practice Address - Street 1:71 HOMECREST CT
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2209
Practice Address - Country:US
Practice Address - Phone:516-766-6283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11848101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)