Provider Demographics
NPI:1588701056
Name:STRENIO, JONATHAN SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:SCOTT
Last Name:STRENIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 MORRILL DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05408-1112
Mailing Address - Country:US
Mailing Address - Phone:802-864-6702
Mailing Address - Fax:
Practice Address - Street 1:96 MORRILL DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05408-1112
Practice Address - Country:US
Practice Address - Phone:802-864-6702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0007474207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine