Organization
ROBERTA K BENNETT MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTA K BENNETT M.D. (OWNER)
(802) 442-3520
Entity
Organization
Contact information
Practice address
160 BENMONT AVE STE 20, BENNINGTON, VT 05201-1842
(802) 442-3570
(802) 447-3392
Mailing address
160 BENMONT AVE STE 20, BENNINGTON, VT 05201-1842
(802) 442-3570
(802) 447-3392
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
042-0007424
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005143
—
VT
Enumeration date
01/03/2011
Last updated
01/03/2011
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