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Theda Burrell
NPI 1922680958 · on the registry since 2021 · sole proprietor
Practice
- Address
- 157-15 19th Ave
Whitestone, NY 11357 - Phone
- (718) 746-0400
- Fax
- (718) 559-0587
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 163W00000X
163W00000X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-04-28
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York