Provider Demographics
NPI:1760742837
Name:BURKE, JUDITH A (CD(DONA) PCD(DONA))
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:BURKE
Suffix:
Gender:F
Credentials:CD(DONA) PCD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 WOOSTER ST
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-1832
Mailing Address - Country:US
Mailing Address - Phone:203-792-3974
Mailing Address - Fax:
Practice Address - Street 1:26 WOOSTER ST
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-1832
Practice Address - Country:US
Practice Address - Phone:203-792-3974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula