Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 042-000-9472 | VT |
NPI | 1013912468 |
---|---|
Provider Name | Dr. Elizabeth F. Jaffe |
First Address | South Burlington, VT 05403-5201 |
Second Address | South Burlington, VT 05403-5201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01744370 | (05) | NM |
0369325-002 | CIGNA (01) | VT |
0VN1559 | (05) | VT |
29424 | BLUE CROSS BLUE SHIELD VT (01) | VT |
321950 | MVP (01) | VT |
82X031 | BCBS NORTHEAST NEW YORK (01) | NY |
G45951 | (02) |