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Individual

DR. TIFFINI JAYE LAKE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
111 COLCHESTER AVE, DEPT OF ANESTHESIOLOGY, BURLINGTON, VT 05401-1473
(802) 847-2415
(802) 847-5324
Mailing address
PO BOX 1063, FLETCHER ALLEN HEALTH CARE, BURLINGTON, VT 05402-1063
(802) 847-2415
(802) 847-5324

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
VT
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1011631
VT
Enumeration date
01/03/2006
Last updated
09/11/2025
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