Provider Demographics
NPI:1386659100
Name:ELSINGER, ERIC (PT)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:ELSINGER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 HIDDEN PINES CIR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VT
Mailing Address - Zip Code:05477-9014
Mailing Address - Country:US
Mailing Address - Phone:802-434-2039
Mailing Address - Fax:
Practice Address - Street 1:85 MAIN ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-8449
Practice Address - Country:US
Practice Address - Phone:802-861-6700
Practice Address - Fax:802-861-2143
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTVT040-00032482251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009289Medicaid
VT4149377OtherMVP
VT5268301OtherFAP
VT9554226OtherCIGNA
VT00048616OtherBCBS
VT48616OtherTVHP
VTELVN3875Medicare ID - Type UnspecifiedPHYSICAL THERAPIST