Healthcare Provider Details

I. General information

NPI: 1548171978
Provider Name (Legal Business Name): MAUREEN BURKE OTD R/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 N 63RD ST
PHILADELPHIA PA
19151-3488
US

IV. Provider business mailing address

845 N 63RD ST
PHILADELPHIA PA
19151-3488
US

V. Phone/Fax

Practice location:
  • Phone: 203-921-7989
  • Fax:
Mailing address:
  • Phone: 203-921-7989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOC021736
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: