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NPI Code Detail

MEDICARE: MRS. KATHRYN DIANNE BURKE OTR

MEDICARE: MRS. KATHRYN DIANNE BURKE OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist6787MA

General Provider Information

NPI Number : 1104941418
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHRYN DIANNE BURKE OTR
Provider Business Mailing Address
First Line : 88 DENVER ST
Second Line :
City : FALL RIVER
State : MA
Zip : 02721-3542
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 863 HATHAWAY RD
Second Line :
City : NEW BEDFORD
State : MA
Zip : 02740-1916
Country : US
Telephone Number : 508-996-6763
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/08/2007

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