| Promed Preferred VT, PLLC | |
|
1 Lawson Ln Ste 200d Burlington VT 05401-8445 | |
| (615) 499-3165 | |
| Not Available |
| Full Name | Promed Preferred VT, PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Lawson Ln Ste 200d, Burlington, Vermont |
| Authorized Official Name and Position | Lev Grinman (OWNER) |
| Authorized Official Contact | 6154993165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Promed Preferred VT, PLLC 329 S Oyster Bay Rd # 2059 Plainview NY 11803-3301 | Promed Preferred VT, PLLC 1 Lawson Ln Ste 200d Burlington VT 05401-8445 Ph: (615) 499-3165 |
| NPI Number | 1225924293 |
|---|---|
| Provider Enumeration Date | 06/16/2025 |
| Last Update Date | 06/16/2025 |
| Certification Date | 06/16/2025 |
| Medicare PECOS PAC ID | 0143720391 |
|---|---|
| Medicare Enrollment ID | O20250822001909 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225924293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Sharon Mansfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992038368 PECOS PAC ID: 5496890493 Enrollment ID: I20160916001564 |
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