Healthcare Provider Details
I. General information
NPI: 1629163654
Provider Name (Legal Business Name): ELAINE S BURKE ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
603 SENECA ST SUITE 5
ONEIDA NY
13421-2653
US
IV. Provider business mailing address
414 UNION ST ATTN: HUMAN RESOURCE
SCHENECTADY NY
12305-1118
US
V. Phone/Fax
- Phone: 315-363-3950
- Fax: 315-363-3951
- Phone: 518-374-5353
- Fax: 518-377-2517
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 172192-1 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | F300034-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: