Provider Demographics
NPI:1881698389
Name:BURKE, THOMAS J (DO)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:BURKE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:774 CHRISTIANA RD STE 107
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-4248
Mailing Address - Country:US
Mailing Address - Phone:302-230-3376
Mailing Address - Fax:302-266-4337
Practice Address - Street 1:774 CHRISTIANA RD STE 107
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4248
Practice Address - Country:US
Practice Address - Phone:302-230-3376
Practice Address - Fax:302-266-4337
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2021-04-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEC20006239207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEH37683Medicare UPIN