Provider Demographics
NPI:1336211903
Name:MARKO, STEFANIE KLEINFELD (DC)
Entity type:Individual
Prefix:DR
First Name:STEFANIE
Middle Name:KLEINFELD
Last Name:MARKO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 WILLISTON RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6078
Mailing Address - Country:US
Mailing Address - Phone:802-863-0334
Mailing Address - Fax:802-862-6604
Practice Address - Street 1:2041 WILLISTON RD
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6078
Practice Address - Country:US
Practice Address - Phone:802-863-0334
Practice Address - Fax:802-862-6604
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006-0000814111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT035-5731OtherBCBS
VT045535-001OtherCIGNA
VT0009386Medicaid
VTT86940Medicare UPIN
VT035-5731OtherBCBS