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General NPI Number Information
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NPI Number | 1013049501
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Entity Type | Individual
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Provider Name | VINCENT MICHAEL BURKE PT, DPT, MPT, BS
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Gender | Male
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Dates
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Enumeration Date | 03/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 19 W PASSAIC ST
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-3213
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Country | US
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Telephone | 201-845-8002
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Fax |
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Provider Business Mailing Address
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Address Line | 310 LOCKWOOD DR
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City | PARAMUS
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State | NJ
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Zip | 07652-3413
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Country | US
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Telephone | 201-261-4128
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | QA00831300
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License Number State | NJ
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