Individual
DR. JOHN ROSS BROOKLYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
368 DORSET ST STE 1, SOUTH BURLINGTON, VT 05403-6236
(802) 860-1441
Mailing address
617 RIVERSIDE AVE, BURLINGTON, VT 05401-1601
(802) 864-6309
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0420008256
VT
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
042-0008256
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009674
—
VT
01
—
0420008256
STATE LICENSE
VT
01
—
08V031
MVP
VT
01
—
1554
VERMONT MANAGED CARE
VT
01
—
1554
BLUE CROSS BLUE SHIELD
—
01
—
385701
CIGNA
—
01
—
9674
TRICARE
—
Enumeration date
12/21/2005
Last updated
08/18/2025
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