Al-Jathiyah Burgess
Student in an Organized Health Care Education/Training Program in Nutley, NJ. Individual provider (NPI-1).
NPI number1508744764
StatusActive
Last updated in NPPESAug 25, 2025
Details
- NPI
- 1508744764
- Entity type
- Individual (NPI-1)
- Name
- Al-Jathiyah Burgess
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 25, 2025
- Certification date
- Aug 25, 2025
- Last updated
- Aug 25, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
340 Kingsland StNutley, NJ 07110-1150
Phone 973-761-9306
Mailing address
340 Kingsland StNutley, NJ 07110-1150
Phone 973-761-9306
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 28 Student in an Organized Health Care Education/Training Program providers in Nutley · All 713 providers in Nutley
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