Provider Demographics
NPI:1710993597
Name:BURKE, WILLIAM F JR (PT, NHA, MBA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:F
Last Name:BURKE
Suffix:JR
Gender:M
Credentials:PT, NHA, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SUFFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06078-2014
Mailing Address - Country:US
Mailing Address - Phone:860-604-3644
Mailing Address - Fax:
Practice Address - Street 1:70 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:SUFFIELD
Practice Address - State:CT
Practice Address - Zip Code:06078-2014
Practice Address - Country:US
Practice Address - Phone:860-604-3644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0059412251G0304X
CT001618376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Not Answered376G00000XNursing Service Related ProvidersNursing Home Administrator