<Unavail>

LBN: Lakeside Pediatrics, Pllc
<Unavail> is an health care organization with primary practice located at 128 Lakeside Ave Suite 115, Burlington VT 05401-4939. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Lakeside Pediatrics, Pllc can be contacted via phone (802) 860-1928, or through Bergeron, Lynn via phone (802) 860-1928.

Contact Information

Primary practice address
128 Lakeside Ave Suite 115 Burlington VT 05401-4939
Phone: (802) 860-1928
Fax: (802) 860-0192
Website:
Map and Directions
Authorized official contact:
Name: Bergeron, Lynn
Phone: (802) 860-1928

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0420006081 Vermont

Profile Details

NPI number 1104880426
LBN Legal business name Lakeside Pediatrics, Pllc
DBA Doing business as <Unavail>
Authorized official Bergeron, Lynn
Entity Organization
Organization subpart 1 No
Enumeration date Apr 13th, 2006
Last updated Aug 27th, 2019 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104880426 NPPES
Vermont Other 33869 MVP
Vermont Other 58026HAGA MVP
Vermont MEDICAID 1007673 MVP

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