Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | VT | |
N | 207XS0106X | Orthopaedic Hand Surgeon | VT |
NPI | 1104842376 |
---|---|
Provider Name | Adam Shafritz |
First Address | South Burlington, VT 05403-5605 |
Second Address | Burlington, VT 05401-3456 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02209378 | NY MEDICAID (01) | NY |
1008398 | (05) | VT |
H20693 | (02) | VT |