Healthcare Provider Details

I. General information

NPI: 1386659100
Provider Name (Legal Business Name): ERIC ELSINGER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 MAIN ST
BURLINGTON VT
05401-8449
US

IV. Provider business mailing address

116 HIDDEN PINES CIR
RICHMOND VT
05477-9014
US

V. Phone/Fax

Practice location:
  • Phone: 802-861-6700
  • Fax: 802-861-2143
Mailing address:
  • Phone: 802-434-2039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberVT040-0003248
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: