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Individual
SARA JEAN REYNOLDS
Active
Individual
SARA JEAN REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
42-0008018
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01342901
—
NY
01
—
042.0008018
LICENSE
VT
05
—
1003556
—
VT
01
—
11415
MOHAWK VALLEY HEALTH PLAN
—
01
—
2112406
VERMONT BLUE CROSS BLUE S
VT
01
—
5082448
AETNA
VT
Enumeration date
06/02/2006
Last updated
07/17/2018
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