Healthcare Provider Details

I. General information

NPI: 1306377486
Provider Name (Legal Business Name): SMITA LAHOTI M.B.B.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2017
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4185 ST GEORGE RD
WILLISTON VT
05495-7695
US

IV. Provider business mailing address

629 COUNTRY CLUB DR
SOUTH BURLINGTON VT
05403-5894
US

V. Phone/Fax

Practice location:
  • Phone: 201-417-0389
  • Fax:
Mailing address:
  • Phone: 201-417-0389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0420015118
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: