Provider Demographics
NPI:1619994654
Name:LANDRIGAN, GARY PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:PATRICK
Last Name:LANDRIGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2119 SPEAR ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:VT
Mailing Address - Zip Code:05445-9288
Mailing Address - Country:US
Mailing Address - Phone:802-847-9393
Mailing Address - Fax:802-847-8198
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:WEST PAVILION-LEVEL 4
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-9393
Practice Address - Fax:802-847-8198
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0008716207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology