=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770055816
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WILLIAM J SARCHINO, DPM
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/31/2018
-----------------------------------------------------
Last Update Date | 01/02/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 343 DEWEY ST
-----------------------------------------------------
City | BENNINGTON
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05201-2253
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-442-2034
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 343 DEWEY ST
-----------------------------------------------------
City | BENNINGTON
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05201-2253
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-442-2034
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | CHARMANE DOW
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 518-692-9060
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------