Provider Demographics
NPI:1699764373
Name:BURKE, HANA S (MD)
Entity type:Individual
Prefix:
First Name:HANA
Middle Name:S
Last Name:BURKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7000 ATRIUM WAY
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054
Mailing Address - Country:US
Mailing Address - Phone:856-291-6818
Mailing Address - Fax:856-291-6819
Practice Address - Street 1:147 EAST THIRD STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-2965
Practice Address - Country:US
Practice Address - Phone:856-234-2500
Practice Address - Fax:856-234-3907
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2020-10-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA79223207Q00000X
NJ25MA07192900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A792232Medicare PIN
CAH65780Medicare UPIN
CA00A792230Medicare PIN
CA00A792231Medicare PIN