Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | ME139479 | FL |
Y | 207YS0123X | Facial Plastic Surgeon | 042.0014822 | VT |
NPI | 1174935381 |
---|---|
Provider Name | Erin Tracy Ostby |
First Address | Burlington, VT 05401-1473 |
Second Address | Burlington, VT 05401-1473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2014 |
Last Update Date | 24/08/2020 |