Provider Demographics
NPI:1073795738
Name:BURKE, JEFFREY DAVID (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DAVID
Last Name:BURKE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N CRAIG ST
Mailing Address - Street 2:STERLING PLAZA, SUITE 408
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1567
Mailing Address - Country:US
Mailing Address - Phone:412-400-6239
Mailing Address - Fax:412-854-0269
Practice Address - Street 1:2801 CUSTER AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15227-3929
Practice Address - Country:US
Practice Address - Phone:412-400-6239
Practice Address - Fax:412-854-0269
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008976L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical