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General NPI Number Information
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NPI Number | 1548382468
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Entity Type | Individual
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Provider Name | SIMON FRISHKOFF N.D.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 145 PINE HAVEN SHORES RD SUITE 2165
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City | SHELBURNE
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State | VT
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Zip | 05482-7703
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Country | US
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Telephone | 802-985-9856
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Fax | 802-985-9846
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Provider Business Mailing Address
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Address Line | 6 LYONS AVE
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-6961
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Country | US
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Telephone | 802-274-0083
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Fax | 802-985-9846
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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 | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 099-0000084
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License Number State | VT
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