Provider Demographics
NPI:1770193385
Name:BURNS, DORIS ISOLDE
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:ISOLDE
Last Name:BURNS
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 1:697 CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-1105
Mailing Address - Country:US
Mailing Address - Phone:908-370-3173
Mailing Address - Fax:
Practice Address - Street 1:697 CRESCENT DR
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1105
Practice Address - Country:US
Practice Address - Phone:908-370-3173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator