Individual
DR. RICHARD WASSERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 S PROSPECT ST, BURLINGTON, VT 05401-3456
(802) 847-4544
(802) 847-4612
Mailing address
1 S PROSPECT ST, ARNOLD 5455, BURLINGTON, VT 05401-3456
(802) 847-4611
(802) 847-8170
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
42-6028
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005600
—
VT
05
—
00775402
—
NY
01
—
BCBS0005609
BLUE CROSS BLUE SHIELD
—
01
—
C65398
CIGNA
—
Enumeration date
07/18/2006
Last updated
07/08/2007
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