| Affiliates In Obstetrical & Gynecological Care Inc | |
|
96 Colchester Ave Burlington VT 05401-1417 | |
| (802) 658-0505 | |
| Not Available |
| Full Name | Affiliates In Obstetrical & Gynecological Care Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 96 Colchester Ave, Burlington, Vermont |
| Authorized Official Name and Position | Patrick Clifford (PRESIDENT) |
| Authorized Official Contact | 8026580505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Affiliates In Obstetrical & Gynecological Care Inc 96 Colchester Ave Burlington VT 05401-1417 Ph: (802) 658-0505 | Affiliates In Obstetrical & Gynecological Care Inc 96 Colchester Ave Burlington VT 05401-1417 Ph: (802) 658-0505 |
| NPI Number | 1104884824 |
|---|---|
| Provider Enumeration Date | 05/02/2006 |
| Last Update Date | 02/04/2013 |
| Medicare PECOS PAC ID | 0244318699 |
|---|---|
| Medicare Enrollment ID | O20080424000755 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104884824 | NPI | - | NPPES |
| 0004930 | Medicaid | VT | |
| CM9478 | Other | VT | RAIL ROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Kimberly D Blake |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265480222 PECOS PAC ID: 5991713380 Enrollment ID: I20060327000511 |
| Provider Name | Dale Lacroix |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922034479 PECOS PAC ID: 8921185554 Enrollment ID: I20080408000085 |
| Provider Name | Patrick P Clifford |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720036783 PECOS PAC ID: 0547347171 Enrollment ID: I20080408000100 |
| Provider Name | Greta Elizabeth Hanson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487872925 PECOS PAC ID: 2860567740 Enrollment ID: I20080813000147 |
| Provider Name | Lia N Wrenn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700128113 PECOS PAC ID: 5799088019 Enrollment ID: I20170807002388 |
| Provider Name | Alexandra C Fenton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205275070 PECOS PAC ID: 2466741475 Enrollment ID: I20190315000453 |
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