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Organization

TIMBER LANE ALLERGY & ASTHMA ASSOCIATES, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDWARD F KENT JR. MD (PRESIDENT)
(802) 864-0294
Entity
Organization

Contact information

Practice address
53 TIMBER LN, SOUTH BURLINGTON, VT 05403-5201
(802) 864-0294
(802) 864-3779
Mailing address
53 TIMBER LN, SOUTH BURLINGTON, VT 05403-5201
(802) 864-0294
(802) 864-3779

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01398301
NY
05
0VN1324
VT
01
28818
BLUE CROSS BLUE SHIELD VT
VT
01
TOO2520
TRICARE
Enumeration date
06/14/2005
Last updated
08/22/2020
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