Organization

Timber Lane Allergy & Asthma Associates, Pc

Allergy & Immunology Physician in South Burlington, VT(View on Map)

Legal Business Name

Timber Lane Allergy & Asthma Associates, Pc

NPI Number

1457356818

NPI Type

Organization

Enumeration Date

06/14/2005

Specialties

(Taxonomies)

Code

207K00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

53 TIMBER LN
53 TIMBER LN

City

South Burlington
South Burlington

State

VT
VT

Postal Code

05403-5201
05403-5201

Country

US
US

Telephone Number

(802) 864-0294
(802) 864-0294

Authorized Official

Name

Dr. Edward Kent

Title or Position

PRESIDENT

Telephone Number

(802) 864-0294

Identifiers

Identifier

01398301
0VN1324
TOO2520
28818

Identifier State

NY
VT
Unknown
VT

Identifier Issuer

Unknown
Unknown
TRICARE
BLUE CROSS BLUE SHIELD VT

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/22/2020

Provider Address