MEDICARE: KAREN CLEARY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	0420008619	VT

General Provider Information

NPI Number	:	1063400190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN CLEARY M.D.

Provider Business Mailing Address
First Line	:	10 MARSETT RD
Second Line	:	STE 1
City	:	SHELBURNE
State	:	VT
Zip	:	05482-6640
Country	:	US
Telephone Number	:	802-985-8055
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 MARSETT RD
Second Line	:	STE 1
City	:	SHELBURNE
State	:	VT
Zip	:	05482-6640
Country	:	US
Telephone Number	:	802-985-8055
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	09/25/2013

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