Burke, Grace Yvonne
Burke, Grace Yvonne is an individual health care provider with primary practice located at 1815 State St , Watertown NY 13601-9406. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Burke, Grace Yvonne can be contacted via phone (315) 788-6070.Contact Information
Primary practice address
1815 State St
Watertown NY 13601-9406
Phone: (315) 788-6070
Fax: (315) 788-1950
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | TUV005387 | New York |
Profile Details
| NPI number | 1821048877 |
|---|---|
| LBN Legal business name | Burke, Grace Yvonne |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 11th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821048877 | NPPES |
| New York | MEDICAID | 01780469 |
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