Healthcare Provider Details

I. General information

NPI: 1245257096
Provider Name (Legal Business Name): GAIL SUSAN YANOWITCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 08/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 FISHER RD STE 1-4 CVMC WOMEN'S HEALTH
BERLIN VT
05602-9000
US

IV. Provider business mailing address

PO BOX 547 CENTRAL VERMONT MEDICAL CENTER - FINANCE DEPT
BARRE VT
05641-0547
US

V. Phone/Fax

Practice location:
  • Phone: 802-371-5961
  • Fax: 802-371-5960
Mailing address:
  • Phone: 802-371-5961
  • Fax: 802-371-5960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number042-0008184
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: