Provider Demographics
NPI:1043572936
Name:KEVIN BURKE INC
Entity Type:Organization
Organization Name:KEVIN BURKE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED
Authorized Official - Phone:718-833-3888
Mailing Address - Street 1:245 96 STREET
Mailing Address - Street 2:APARTMENT D8
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-6840
Mailing Address - Country:US
Mailing Address - Phone:718-833-3888
Mailing Address - Fax:
Practice Address - Street 1:245 96TH ST
Practice Address - Street 2:APARTMENT D8
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-6847
Practice Address - Country:US
Practice Address - Phone:718-833-3888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty