Healthcare Provider Details

I. General information

NPI: 1124597331
Provider Name (Legal Business Name): DR. JANET BURKE BCBA-D,LBA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2018
Last Update Date: 11/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 CHARTER RIDGE DR
SANDY HOOK CT
06482-1574
US

IV. Provider business mailing address

50 CHARTER RIDGE DR
SANDY HOOK CT
06482-1574
US

V. Phone/Fax

Practice location:
  • Phone: 914-826-1125
  • Fax:
Mailing address:
  • Phone: 914-826-1125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: DR. DR. JANET BURKE BCBA D LBA
Title or Position: PRESIDENT
Credential:
Phone: 914-826-1125