Provider Demographics
NPI:1235242819
Name:BURKE, JOSEPH STEVEN (DPM)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:STEVEN
Last Name:BURKE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2791 JERUSALEM AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-1833
Mailing Address - Country:US
Mailing Address - Phone:516-826-9000
Mailing Address - Fax:516-826-9036
Practice Address - Street 1:2791 JERUSALEM AVE
Practice Address - Street 2:
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1833
Practice Address - Country:US
Practice Address - Phone:516-826-9000
Practice Address - Fax:516-826-9036
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNOO39896-1213E00000X
TX928213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00903228Medicaid
NY00903228Medicaid
NYT51249Medicare UPIN