Provider Demographics
NPI:1922015817
Name:BURKE, HELEN MARIAN (CNM)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:MARIAN
Last Name:BURKE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MISS
Other - First Name:HELEN
Other - Middle Name:MARIAN
Other - Last Name:BRYDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:1 DELAWARE AVENUE
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:NY
Mailing Address - Zip Code:12754
Mailing Address - Country:US
Mailing Address - Phone:845-292-4314
Mailing Address - Fax:
Practice Address - Street 1:23 HIGH STREET
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12754
Practice Address - Country:US
Practice Address - Phone:845-794-5558
Practice Address - Fax:845-794-0135
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000068367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife