Healthcare Provider Details

I. General information

NPI: 1215826508
Provider Name (Legal Business Name): AMANDA SOPHIA BURKE MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2857 LINDEN BLVD
BROOKLYN NY
11208-5126
US

IV. Provider business mailing address

179 EINSTEIN WAY
EAST WINDSOR NJ
08512-2541
US

V. Phone/Fax

Practice location:
  • Phone: 718-908-8000
  • Fax: 718-277-0822
Mailing address:
  • Phone: 609-613-3307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: