Provider Demographics
NPI:1194804096
Name:ASSOCIATES IN ORTHOPAEDIC SURGERY, PC
Entity type:Organization
Organization Name:ASSOCIATES IN ORTHOPAEDIC SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:CORCORAN
Authorized Official - Suffix:
Authorized Official - Credentials:FACMPE
Authorized Official - Phone:802-862-3983
Mailing Address - Street 1:6 SAN REMO DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05461
Mailing Address - Country:US
Mailing Address - Phone:802-862-3983
Mailing Address - Fax:802-863-7994
Practice Address - Street 1:6 SAN REMO DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05461
Practice Address - Country:US
Practice Address - Phone:802-862-3983
Practice Address - Fax:802-863-7994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN1102Medicaid
VT0260810001Medicare NSC
VTVN1102Medicare PIN