Lisa N.Burke,PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

30291 Issued in NY

Legal business name

LISA N.BURKE,PA

Practice address

5645 Main St
RM W238
Flushing, NY 11355-5045

Phone

(718) 670-2501

Fax

(718) 670-1864

NPI assigned

Jun 6, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Prof. Lisa N Burke, PA

Title

PA

Phone

(718) 670-2501

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568401487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "address_2": "RM W238",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-670-2501",
            "fax_number": "718-670-1864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "address_2": "RM W238",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-670-2501",
            "fax_number": "718-670-1864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA N.BURKE,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PA",
        "authorized_official_telephone_number": "718-670-2501",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "30291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Flushing, NY
• Providers in Flushing, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.