Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 248222 | NY |
N | 207Q00000X | Family Doctor | MD10890 | RI |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 042.0013387 | VT |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 248222 | NY |
NPI | 1073596847 |
---|---|
Provider Name | Robert E Gramling |
First Address | Burlington, VT 05401-1473 |
Second Address | Burlington, VT 05401-1473 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2005 |
Last Update Date | 16/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000933333001 | HEALTHNOW (01) | NY |
0279404 | GHI (01) | NY |
9022639 | (05) | RI |
H42952 | (02) | RI |