Provider Demographics
NPI:1871223693
Name:BURKE, COLLEEN C
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:C
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 1:10B MADISON AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-7314
Mailing Address - Country:US
Mailing Address - Phone:518-867-3061
Mailing Address - Fax:
Practice Address - Street 1:85 MAPLE RD
Practice Address - Street 2:
Practice Address - City:VOORHEESVILLE
Practice Address - State:NY
Practice Address - Zip Code:12186-9531
Practice Address - Country:US
Practice Address - Phone:518-807-7799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator