Provider Demographics
NPI:1558774117
Name:MIGONIS, ALISON MARIE (DPM)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:MARIE
Last Name:MIGONIS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:MARIE
Other - Last Name:LESHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:65 SAINT JAMES CIR
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1728
Mailing Address - Country:US
Mailing Address - Phone:315-663-6412
Mailing Address - Fax:
Practice Address - Street 1:130 FISHER RD STE 4
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9516
Practice Address - Country:US
Practice Address - Phone:802-371-4460
Practice Address - Fax:802-371-4435
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VT056.0000192213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program