Healthcare Provider Details

I. General information

NPI: 1174403885
Provider Name (Legal Business Name): NATALIE BURKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 EASTERN PKWY
BROOKLYN NY
11233-5270
US

IV. Provider business mailing address

14418 107TH AVE
JAMAICA NY
11435-5232
US

V. Phone/Fax

Practice location:
  • Phone: 929-445-0624
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number127428
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: