Basic Information
| Provider Information | |||||||||
| NPI: | 1578722286 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURCH | ||||||||
| FirstName: | JODI | ||||||||
| MiddleName: | LIN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | NPP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 530 FRANKLIN ST | ||||||||
| Address2: | |||||||||
| City: | SCHENECTADY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 123052008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5183818911 | ||||||||
| FaxNumber: | 5185141383 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 CRESCENT AVE | ||||||||
| Address2: | |||||||||
| City: | SARATOGA SPRINGS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128665142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5185843600 | ||||||||
| FaxNumber: | 5185839301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2008 | ||||||||
| LastUpdateDate: | 06/18/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 401130 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.