| Boreal Psychiatry Plc | |
|
4185 St George Rd Williston VT 05495-7695 | |
| (802) 636-4545 | |
| Not Available |
| Full Name | Boreal Psychiatry Plc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4185 St George Rd, Williston, Vermont |
| Authorized Official Name and Position | Kyle Monahan (OWNER) |
| Authorized Official Contact | 8026364545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boreal Psychiatry Plc 4185 St George Rd Williston VT 05495-7695 Ph: (802) 636-4545 | Boreal Psychiatry Plc 4185 St George Rd Williston VT 05495-7695 Ph: (802) 636-4545 |
| NPI Number | 1780314211 |
|---|---|
| Provider Enumeration Date | 06/16/2022 |
| Last Update Date | 06/16/2022 |
| Certification Date | 06/16/2022 |
| Medicare PECOS PAC ID | 3971988924 |
|---|---|
| Medicare Enrollment ID | O20220913000189 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780314211 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Kyle J Monahan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598269565 PECOS PAC ID: 8729342308 Enrollment ID: I20220913000258 |
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