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Individual

GEOFFREY KANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
ANNA MARSH LANE, BRATTLEBORO, VT 05302-0803
(802) 257-7785
Mailing address
ANNA MARSH LANE, BRATTLEBORO, VT 05302-0803
(802) 257-7785

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
042-0010667
VT
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
042-0010667
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
VT 1010344
VT
Enumeration date
10/04/2005
Last updated
03/12/2009
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