Provider Demographics
NPI:1952410680
Name:BURKE, PATRICIA A (MD PHD)
Entity type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:A
Last Name:BURKE
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SEARS DRIVE 4TH FL
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-599-0123
Mailing Address - Fax:201-599-0934
Practice Address - Street 1:1 SEARS DRIVE 4TH FL
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-599-0123
Practice Address - Fax:201-599-0934
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA056852207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJBU700421Medicare ID - Type Unspecified
E94661Medicare UPIN