Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 25MA04577700 | NJ |
N | 207VE0102X | Reproductive Endocrinologist | 25MA04577700 | NJ |
NPI | 1275611295 |
---|---|
Provider Name | Dr. Gerald V Burke |
First Address | Stratford, NJ 08084-1354 |
Second Address | Stratford, NJ 08084-1354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 10/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2293005 | (05) | NJ |
C53250 | (02) | NJ |