Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 0420013724 | VT |
NPI | 1013450840 |
---|---|
Provider Name | Dr. Jessica Ryniec |
First Address | Burlington, VT 05401-1473 |
Second Address | Burlington, VT 05401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2016 |
Last Update Date | 11/07/2018 |