Provider Demographics
NPI:1629113386
Name:WHITE, ELIZABETH SOSNA (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SOSNA
Last Name:WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:41 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:ESSEX JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05452-2240
Mailing Address - Country:US
Mailing Address - Phone:802-878-2402
Mailing Address - Fax:
Practice Address - Street 1:93 PILGRIM PARK RD
Practice Address - Street 2:SUITE 6
Practice Address - City:WATERBURY
Practice Address - State:VT
Practice Address - Zip Code:05676-1727
Practice Address - Country:US
Practice Address - Phone:802-241-2464
Practice Address - Fax:802-507-5485
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT0420008531207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine