Provider Demographics
NPI:1639387517
Name:BURNS, ROBERT A (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:BURNS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11021 73RD RD
Mailing Address - Street 2:SUITE 1J
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6348
Mailing Address - Country:US
Mailing Address - Phone:917-797-4220
Mailing Address - Fax:718-747-6282
Practice Address - Street 1:11021 73RD RD
Practice Address - Street 2:SUITE 1J
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-6348
Practice Address - Country:US
Practice Address - Phone:917-797-4220
Practice Address - Fax:718-747-6282
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3973103T00000X
NY000211106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist