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General NPI Number Information
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NPI Number | 1366469447
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Entity Type | Organization
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Legal Business Name | SHERIDAN HEALTHCARE OF VERMONT INC
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 09/18/2019
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Provider Practice Location Address
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Address Line | 160 ALLEN ST
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City | RUTLAND
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State | VT
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Zip | 05701-4560
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Country | US
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Telephone | 802-775-7111
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Fax | 954-851-1758
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Provider Business Mailing Address
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Address Line | PO BOX 744544
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City | ATLANTA
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State | GA
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Zip | 30374-4544
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Country | US
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Telephone | 954-838-2371
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Fax | 913-242-6850
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Authorized Official
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Title or Position | OFFICER
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Name | KATHLEEN KONDAS
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Credential |
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Telephone | 954-838-2371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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