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General NPI Number Information
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NPI Number | 1871699868
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Entity Type | Individual
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Provider Name | MAUREEN BURKE FRANKLIN RD
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Gender | Female
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4900 BROAD RD NUTRITION CENTER
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City | SYRACUSE
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State | NY
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Zip | 13215-2265
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Country | US
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Telephone | 315-492-5063
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Fax | 315-492-5002
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Provider Business Mailing Address
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Address Line | 217 SLAWSON DR
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City | CAMILLUS
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State | NY
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Zip | 13031-2320
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Country | US
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Telephone | 315-487-9169
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 001063-1
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License Number State | NY
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