Provider Demographics
NPI:1851574222
Name:BURKE, ROBIE (OD)
Entity Type:Individual
Prefix:
First Name:ROBIE
Middle Name:
Last Name:BURKE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 KATONAH AVE
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-2142
Mailing Address - Country:US
Mailing Address - Phone:914-232-4061
Mailing Address - Fax:
Practice Address - Street 1:198 KATONAH AVE
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-2142
Practice Address - Country:US
Practice Address - Phone:914-232-4061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003961-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician