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General NPI Number Information
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NPI Number | 1952332124
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Entity Type | Organization
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Legal Business Name | ALDER BROOK FAMILY HEALTH P.C.
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 03/01/2016
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Provider Practice Location Address
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Address Line | 8 ESSEX WAY SUITE 201
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City | ESSEX JUNCTION
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State | VT
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Zip | 05452-3425
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Country | US
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Telephone | 802-872-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 8 ESSEX WAY SUITE 201
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City | ESSEX JUNCTION
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State | VT
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Zip | 05452-3425
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Country | US
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Telephone | 802-872-7100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DIANE C. RIPPA
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Credential | M.D.
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Telephone | 802-872-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0420007492
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License Number State | VT
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