Provider Demographics
NPI:1306915681
Name:FITZHARRIS-ONYON, TERESA KATHLEEN (MD)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:KATHLEEN
Last Name:FITZHARRIS-ONYON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTERFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03466
Mailing Address - Country:US
Mailing Address - Phone:603-256-6780
Mailing Address - Fax:
Practice Address - Street 1:17 BELMONT AVE
Practice Address - Street 2:BRATTLEBORO EMERGENCY SERVICES INC
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301
Practice Address - Country:US
Practice Address - Phone:802-257-8382
Practice Address - Fax:802-251-8466
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420008912207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN0832Medicaid
19603OtherVT BLUE SHIELD
VTVN0832Medicare ID - Type Unspecified
VT0VN0832Medicaid