Provider Demographics
NPI:1033835277
Name:MDF GERIATRIC HEALTHCARE PC
Entity Type:Organization
Organization Name:MDF GERIATRIC HEALTHCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DOMININCA
Authorized Official - Last Name:FATIGATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-673-4916
Mailing Address - Street 1:46 LAKEMONT RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-9690
Mailing Address - Country:US
Mailing Address - Phone:802-673-4916
Mailing Address - Fax:
Practice Address - Street 1:46 LAKEMONT RD
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-9690
Practice Address - Country:US
Practice Address - Phone:802-673-4916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty