Provider Demographics
NPI:1356458087
Name:FLETCHER ALLEN HEALTH CARE
Entity Type:Organization
Organization Name:FLETCHER ALLEN HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NNP
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUSSDORFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-847-2370
Mailing Address - Street 1:111 COLCHESTER AVE
Mailing Address - Street 2:MCCLURE 7 - NICU
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-0000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:MCCLURE 7 - NICU
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-2370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren