Provider Demographics
NPI:1407800444
Name:MAITRI HEALTH CARE FOR WOMEN PC
Entity Type:Organization
Organization Name:MAITRI HEALTH CARE FOR WOMEN PC
Other - Org Name:MAITRI HEALTH CARE FOR WOMEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-862-7338
Mailing Address - Street 1:185 TILLEY DR
Mailing Address - Street 2:STE 57
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-4484
Mailing Address - Country:US
Mailing Address - Phone:802-862-7338
Mailing Address - Fax:802-862-8411
Practice Address - Street 1:185 TILLEY DR
Practice Address - Street 2:STE 57
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-4484
Practice Address - Country:US
Practice Address - Phone:802-862-7338
Practice Address - Fax:802-862-8411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009627Medicaid
VT1009627Medicaid
UTMAVN3131Medicare ID - Type UnspecifiedMEDICARE