Provider Demographics
NPI:1447263272
Name:BURKE, JOY ELLEN (MD)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:ELLEN
Last Name:BURKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:ELLEN
Other - Last Name:DREIBELBIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:41 MALL RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8000
Mailing Address - Fax:
Practice Address - Street 1:2655 RIDGEWAY AVE
Practice Address - Street 2:SUITE 420
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4296
Practice Address - Country:US
Practice Address - Phone:585-723-7972
Practice Address - Fax:585-368-3119
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2523642084N0400X
MA2867032084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03255098Medicaid
NY03255098Medicaid
NYJ400048419/70008AGRPMedicare PIN