Individual
PETA BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
181 PATRICIA M GENOVA DR, NEWINGTON, CT 06111-1500
(860) 696-2534
(860) 696-2525
Mailing address
181 PATRICIA M GENOVA DR, NEWINGTON, CT 06111-1500
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2682
CT
Other
Enumeration date
05/04/2010
Last updated
05/04/2010
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