Provider Demographics
NPI:1912269655
Name:BURZAN, JOYC
Entity type:Individual
Prefix:
First Name:JOYC
Middle Name:
Last Name:BURZAN
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 1:16 HASBROUCK PL
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-5120
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4184 ROUTE 9W
Practice Address - Street 2:
Practice Address - City:WEST CAMP
Practice Address - State:NY
Practice Address - Zip Code:12464
Practice Address - Country:US
Practice Address - Phone:845-247-0941
Practice Address - Fax:845-246-8537
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator