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General NPI Number Information
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NPI Number | 1194843334
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Entity Type | Individual
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Provider Name | LYNN C ATHERINE BURKE RPT,MS,CCI
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 100 DEERFIELD RD
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City | WINDSOR
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State | CT
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Zip | 06095-4252
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Country | US
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Telephone | 860-714-1922
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Fax |
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Provider Business Mailing Address
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Address Line | 43 LOCUST ST
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City | MANCHESTER
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State | CT
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Zip | 06040-5122
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Country | US
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Telephone | 860-647-1939
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 005866
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License Number State | CT
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