Provider Demographics
NPI:1508646050
Name:BURKE, DONNA
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:BURKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960 2ND ST SE APT 31
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-1760
Mailing Address - Country:US
Mailing Address - Phone:301-256-2756
Mailing Address - Fax:
Practice Address - Street 1:1320 GOOD HOPE RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-6912
Practice Address - Country:US
Practice Address - Phone:202-610-1886
Practice Address - Fax:202-610-1887
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty