Burroughs, Larry

Burroughs, Larry is an individual health care provider with primary practice located at 86 S Harrison St Ste A , East Orange NJ 07018-1748. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Burroughs, Larry can be contacted via phone (973) 324-7891.

Contact Information

Primary practice address
86 S Harrison St Ste A East Orange NJ 07018-1748
Phone: (973) 324-7891
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X New Jersey

Profile Details

NPI number 1326505447
LBN Legal business name Burroughs, Larry
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 25th, 2019
Last updated Feb 25th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326505447 NPPES
New Jersey MEDICAID 6466403618210

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