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General NPI Number Information
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NPI Number | 1285945063
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Entity Type | Individual
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Provider Name | LARISA BURKE PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 06/28/2010
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Last Update Date | 06/28/2010
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Provider Practice Location Address
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Address Line | 728 E PULASKI HWY
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City | ELKTON
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State | MD
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Zip | 21921-6029
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Country | US
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Telephone | 410-398-9595
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Fax | 410-398-8179
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Provider Business Mailing Address
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Address Line | 110 LINDEN TREE LN
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City | NEWARK
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State | DE
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Zip | 19711-7232
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Country | US
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Telephone | 302-588-3663
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18334
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | A1-0003887
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License Number State | DE
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