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General NPI Number Information
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NPI Number | 1750525192
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Entity Type | Individual
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Provider Name | JONATHAN N FLYER M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 111 COLCHESTER AVENUE UNIVERSITY OF VERMONT MEDICAL CENTER
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City | BURLINGTON
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State | VT
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Zip | 05401-1573
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Country | US
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Telephone | 802-847-0000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1063 UVM MEDICAL CENTER
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City | BURLINGTON
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State | VT
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Zip | 05402-1063
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Country | US
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Telephone | 802-847-0000
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 050556
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 278442
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 042-0013411
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License Number State | VT
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