Healthcare Provider Details

I. General information

NPI: 1982925244
Provider Name (Legal Business Name): ABIGAIL R ADLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE FAHC
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

195 HOWARD ST APT 3
BURLINGTON VT
05401-4032
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-0000
  • Fax:
Mailing address:
  • Phone: 802-338-6417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number042.0012603
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number288823-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number042.0012603
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: