Provider Demographics
NPI:1043616824
Name:TODD-BURKE, KRISTA MCSHEA (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:MCSHEA
Last Name:TODD-BURKE
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 CHESTER PIKE
Mailing Address - Street 2:PROSPECT PARK HEALTH AND REHABILITATION CENTER
Mailing Address - City:PROSPECT PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19076
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:815 CHESTER PIKE
Practice Address - Street 2:PROSPECT PARK HEALTH AND REHABILITATION CENTER
Practice Address - City:PROSPECT PARK
Practice Address - State:PA
Practice Address - Zip Code:19076
Practice Address - Country:US
Practice Address - Phone:610-389-9483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOCO10608225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist