Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 042.0014054 | VT |
Y | 111NI0900X | Internist | 042.0014054 | VT |
N | 207RP1001X | Pulmonary Disease | 303943 | NY |
NPI | 1053725200 |
---|---|
Provider Name | Brett Erdreich |
First Address | Burlington, VT 05401-1473 |
Second Address | Berlin, VT 05602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2014 |
Last Update Date | 05/05/2020 |