MEDICARE: CAROLYN SARAH LORENZ-GREENBERG MD

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	208000000X	Pediatrics Physician	5584	AK
2	208000000X	Pediatrics Physician	0420012009	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770704744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN SARAH LORENZ-GREENBERG MD

Provider Business Mailing Address
First Line	:	PO BOX 547
Second Line	:	CENTRAL VERMONT MEDICAL CENTER - FINANCE DEPT
City	:	BARRE
State	:	VT
Zip	:	05641-0547
Country	:	US
Telephone Number	:	802-371-5950
Fax Number	:	802-371-5951

Provider Business Practice Location Address
First Line	:	246 GRANGER RD
Second Line	:	SUITE 1
City	:	BERLIN
State	:	VT
Zip	:	05602-0000
Country	:	US
Telephone Number	:	802-371-5950
Fax Number	:	802-371-5951

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

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	12/04/2014

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