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Provider Information for 1902266091


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JOSH BURKE


Sex: Male

NPI: 1902266091
Last Updated: 2016-03-02
Certification Date:

Details

NameValue
NPI1902266091
Enumeration Date2016-03-02
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 224 ALEXANDER ST
ROCHESTER, NY 14607-4000
United States

Phone: 585-922-7770 | Fax:
 
Primary Practice Address 1425 PORTLAND AVE
ROCHESTER, NY 14621-3001
United States

Phone: 585-922-4000 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 104100000X - Social Worker NY090537-1