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NPI Code Detail

MEDICARE: DR. ROBERT R ALTHOFF MD PHD

MEDICARE: DR. ROBERT R ALTHOFF MD PHD
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
12084P0800XPsychiatry Physician042.0011155VT
22084P0800XPsychiatry Physician290106NY
32084P0804XChild & Adolescent Psychiatry Physician042-0011155VT

General Provider Information

NPI Number : 1275514713
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT R ALTHOFF MD PHD
Provider Business Mailing Address
First Line : 1 S PROSPECT ST
Second Line : FLETCHER ALLEN HEALTH CARE
City : BURLINGTON
State : VT
Zip : 05401-3456
Country : US
Telephone Number : 802-847-4563
Fax Number : 802-847-7998
Provider Business Practice Location Address
First Line : 1 S PROSPECT ST
Second Line : FLETCHER ALLEN HEALTH CARE
City : BURLINGTON
State : VT
Zip : 05401-3456
Country : US
Telephone Number : 802-847-4563
Fax Number : 802-847-7998
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2005
Last Update Date : 02/01/2022

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