Provider Demographics
NPI:1255451217
Name:ALAN N. BINNICK, M.D., P.C.
Entity type:Organization
Organization Name:ALAN N. BINNICK, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:BINNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-447-7441
Mailing Address - Street 1:140 HOSPITAL DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-5009
Mailing Address - Country:US
Mailing Address - Phone:802-447-7441
Mailing Address - Fax:802-447-0254
Practice Address - Street 1:140 HOSPITAL DR
Practice Address - Street 2:SUITE 109
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-5009
Practice Address - Country:US
Practice Address - Phone:802-447-7441
Practice Address - Fax:802-447-0254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0005614207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1075267Medicaid
VTVT5267Medicare ID - Type Unspecified
A67767Medicare UPIN