Provider Demographics
NPI:1265098834
Name:BURGER, CAROLE KAMEN (MS PT)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:KAMEN
Last Name:BURGER
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:23 HORSESHOE CIR
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-1722
Mailing Address - Country:US
Mailing Address - Phone:860-874-2071
Mailing Address - Fax:
Practice Address - Street 1:60 EBEN BROWN LN
Practice Address - Street 2:
Practice Address - City:CENTRAL FALLS
Practice Address - State:RI
Practice Address - Zip Code:02863-1409
Practice Address - Country:US
Practice Address - Phone:401-722-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-19
Last Update Date:2019-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT03169225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist