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General NPI Number Information
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NPI Number | 1427686906
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Entity Type | Individual
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Provider Name | SHAUNAK KRISHAN BAKSHI
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Gender | Male
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 08/03/2025
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Provider Practice Location Address
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Address Line | 1100 HINESBURG RD STE 201
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-7613
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Country | US
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Telephone | 802-862-1808
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 HINESBURG RD STE 201
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-7613
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 338674-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 042.0018755
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License Number State | VT
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