Healthcare Provider Details

I. General information

NPI: 1215035530
Provider Name (Legal Business Name): ELIZABETH ANN MCLARNEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 BELMONT AVENUE SUITE #2
BRATTLEBORO VT
05301
US

IV. Provider business mailing address

17 BELMONT AVENUE SUITE #2
BRATTLEBORO VT
05301
US

V. Phone/Fax

Practice location:
  • Phone: 802-254-7787
  • Fax: 802-254-5937
Mailing address:
  • Phone: 802-254-7787
  • Fax: 802-254-5937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number0420010156
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number042-0010156
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number0420010156
License Number StateVT
# 4
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number0420010156
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: