Organization
UPTOWN NOLA PSYCH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEO J BURKE III MP (MEDICAL PSYCHOLOGIST)
(504) 232-7338
Entity
Organization
Contact information
Practice address
7611 MAPLE ST, SUITE B3, NEW ORLEANS, LA 70118-5068
(504) 232-7338
(504) 323-1992
Mailing address
1315 WALNUT ST, SUITE 805, PHILADELPHIA, PA 19107-4719
(215) 805-9445
(215) 545-8496
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1375
LA
103TC2200X
Clinical Child & Adolescent Psychologist
1375
LA
103TP0016X
Prescribing (Medical) Psychologist
Primary
MP304056
LA
Other
Enumeration date
11/18/2016
Last updated
11/18/2016
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