Provider Demographics
NPI:1477173300
Name:BURKE, MAUREEN HOWELL (RN)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:HOWELL
Last Name:BURKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 MAIDEN LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14615-1230
Mailing Address - Country:US
Mailing Address - Phone:585-966-3605
Mailing Address - Fax:
Practice Address - Street 1:750 MAIDEN LN
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14615-1230
Practice Address - Country:US
Practice Address - Phone:585-966-3605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY682109-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer