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:
Health care specialties
| Specialty | Code | License # | 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 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619978293 | NPPES |
| New York | MEDICAID | 01263758 |
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