Jennifer Burdish

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-16-24856 Issued in NY

Practice address

3 Norton Ave
Port Jefferson Station, NY 11776-4402

Phone

(631) 831-6988

NPI assigned

Sep 29, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1669921722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NORTON AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117764402",
            "telephone_number": "631-831-6988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 NORTON AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117764402",
            "telephone_number": "631-831-6988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDISH",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-29",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "742427131",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "926923151",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1-16-24856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Buchrieser
• Brenna Katherine Buckstein, MSPAS, PA-C
• Rose M Bukovsky, ANP
• Jessica Buonomo, LMT
• Michael Angelo Buonomo I, MS.ED.,PH.D.
• Fern M Burke, LPN
• William Burke, R.PH.
• Stephanie Bux, MA CCC-SLP
• BV Port Jefferson Operator, LLC
• Valentina Cabebe

• Behavior Analyst in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.