Healthcare Provider Details

I. General information

NPI: 1487224713
Provider Name (Legal Business Name): DANIELLE BURKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2021
Last Update Date: 06/29/2021
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W MAIN ST UNIT H
SALUNGA PA
17538-1109
US

IV. Provider business mailing address

370 ANCHOR RD
ELIZABETHTOWN PA
17022-2807
US

V. Phone/Fax

Practice location:
  • Phone: 717-892-6740
  • Fax:
Mailing address:
  • Phone: 717-805-8603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZA2600X
TaxonomyMedical Art Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: