Hetzler, Theresa

Hetzler, Theresa is an individual health care provider with primary practice located at 617 Riverside Ave , Burlington VT 05401-1601. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Hetzler, Theresa can be contacted via phone (802) 864-6309.

Contact Information

Primary practice address
617 Riverside Ave Burlington VT 05401-1601
Phone: (802) 864-6309
Fax: (802) 860-4313
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 181118 New York
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 042.0013055 Vermont

Profile Details

NPI number 1619978293
LBN Legal business name Hetzler, Theresa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Jun 28th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619978293 NPPES
New York MEDICAID 01263758

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