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General NPI Number Information
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NPI Number | 1750259792
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Entity Type | Individual
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Provider Name | KATE MIRANDA BOURKE RD
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Gender | Female
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Dates
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Enumeration Date | 10/29/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 135 HIGHWAY 35
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City | EATONTOWN
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State | NJ
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Zip | 07724-1813
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Country | US
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Telephone | 885-660-4325
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Fax | 848-300-2207
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Provider Business Mailing Address
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Address Line | 331 NEWMAN SPRINGS RD STE 220
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City | RED BANK
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State | NJ
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Zip | 07701-5792
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Country | US
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Telephone | 732-807-0877
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Fax | 201-751-1680
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 86372624
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License Number State | NJ
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