Burke, Kenneth L

Burke, Kenneth L is an individual health care provider with primary practice located at 175 Main St S , Woodbury CT 06798-3405. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Burke, Kenneth L can be contacted via phone (203) 263-3391.

Contact Information

Primary practice address
175 Main St S Woodbury CT 06798-3405
Phone: (203) 263-3391
Fax: (203) 263-3390
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 000817 Connecticut

Profile Details

NPI number 1881608263
LBN Legal business name Burke, Kenneth L
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Mar 26th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881608263 NPPES
Connecticut Other 83587 AETNA
Connecticut Other 090000817CT01 AETNA
Connecticut Other 3582 AETNA
Connecticut Other P382850 AETNA
Connecticut Other 009287 AETNA
Connecticut Other 658049 AETNA
Connecticut Other 0V0992 AETNA

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