Healthcare Provider Details

I. General information

NPI: 1134430135
Provider Name (Legal Business Name): MATTHEW M BURKE APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2010
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 PARK ST
NEW HAVEN CT
06519-1110
US

IV. Provider business mailing address

35 PARK ST
NEW HAVEN CT
06519-1110
US

V. Phone/Fax

Practice location:
  • Phone: 203-200-6622
  • Fax:
Mailing address:
  • Phone: 203-200-6622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95081245
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number004419
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: