Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 042.0013175 | VT |
N | 208200000X | Surgeon | MT193467 | PA |
N | 208600000X | Surgeon | MT193467 | PA |
NPI | 1386887818 |
---|---|
Provider Name | Dr. Jaime Pineda |
First Address | Burlington, VT 05401 |
Second Address | Burlington, VT 05401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2009 |
Last Update Date | 12/08/2015 |