Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 003285-1 | NY |
N | 225XM0800X | Mental Health | 003285-1 | NY |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 003285-1 | NY |
N | 225XP0200X | Occupational Therapist - Pediatrics | 003285-1 | NY |
NPI | 1881900223 |
---|---|
Provider Name | Jennifer Lynn Burke |
First Address | Niskayuna, NY 12309-1967 |
Second Address | Albany, NY 12203-3496 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2010 |
Last Update Date | 23/08/2010 |