| Paul Foxman, Ph.d., Inc. | |
|
112 Lake St Burlington VT 05401-5284 | |
| (802) 865-3450 | |
| (802) 859-3309 |
| Full Name | Paul Foxman, Ph.d., Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 112 Lake St, Burlington, Vermont |
| Authorized Official Name and Position | Paul Foxman (PRESIDENT) |
| Authorized Official Contact | 8028653450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul Foxman, Ph.d., Inc. 86 Lake St Burlington VT 05401-5284 Ph: (802) 865-3450 | Paul Foxman, Ph.d., Inc. 112 Lake St Burlington VT 05401-5284 Ph: (802) 865-3450 |
| NPI Number | 1083867287 |
|---|---|
| Provider Enumeration Date | 10/31/2008 |
| Last Update Date | 04/26/2018 |
| Medicare PECOS PAC ID | 8820151616 |
|---|---|
| Medicare Enrollment ID | O20090105000444 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083867287 | NPI | - | NPPES |
| 0006558 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 0480000185 (Vermont) | Primary |
| Provider Name | Paul Foxman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679591895 PECOS PAC ID: 5092755504 Enrollment ID: I20050504000484 |
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