1801891049 NPI number — DR. JANET Y HINZMAN MD

Table of content: DR. JANET Y HINZMAN MD (NPI 1801891049)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801891049 NPI number — DR. JANET Y HINZMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HINZMAN
Provider First Name:
JANET
Provider Middle Name:
Y
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FLANDREAU
Provider Other First Name:
JANET
Provider Other Middle Name:
H
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1801891049
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
286 HOSPITAL LOOP
Provider Second Line Business Mailing Address:
STE 2
Provider Business Mailing Address City Name:
BERLIN
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05602-8496
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-223-6169
Provider Business Mailing Address Fax Number:
802-223-8910

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
286 HOSPITAL LOOP
Provider Second Line Business Practice Location Address:
STE 2
Provider Business Practice Location Address City Name:
BERLIN
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05602-8496
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-223-6169
Provider Business Practice Location Address Fax Number:
802-223-8910
Provider Enumeration Date:
06/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  042-0006588 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 07208 . This is a "MVP" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: T000268 . This is a "TRICARE" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 042-0006588 . This is a "STATE LICENSE" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 0005288 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: HINZ00005288 . This is a "BLUE SHIELD" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 72910 . This is a "CIGNA" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".




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