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General NPI Number Information
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NPI Number | 1124291372
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Entity Type | Organization
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Legal Business Name | ROBIE BURKE OPTICIANS
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 198 KATONAH AVE
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City | KATONAH
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State | NY
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Zip | 10536-2142
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Country | US
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Telephone | 914-232-4061
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Fax | 914-232-4061
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Provider Business Mailing Address
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Address Line | 198 KATONAH AVE
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City | KATONAH
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State | NY
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Zip | 10536-2142
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Country | US
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Telephone | 914-232-4061
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Fax | 914-232-4061
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Authorized Official
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Title or Position | OPTICIAN
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Name | MR. ROBIE BURKE
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Credential | OD
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Telephone | 914-232-4061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 003961-1
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License Number State | NY
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