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Organization
RAINBOW PEDIATRICS
Active
Organization
RAINBOW PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA RYAN (OFFICE MANAGER)
(802) 388-1338
Entity
Organization
Contact information
Practice address
44 COLLINS DR, SUITE 202, MIDDLEBURY, VT 05753-8528
(802) 388-1338
(802) 388-8244
Mailing address
44 COLLINS DR, SUITE 202, MIDDLEBURY, VT 05753-8528
(802) 388-1338
(802) 388-8244
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006825
—
VT
01
—
1287939
CIGNA GROUP NUMBER
VT
01
—
39687
BCVT GROUP NUMBER
VT
Enumeration date
06/21/2006
Last updated
08/22/2020
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