Provider Demographics
NPI:1831507664
Name:CRAIG RINDER, MD, LLC
Entity type:Organization
Organization Name:CRAIG RINDER, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:RINDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-254-8222
Mailing Address - Street 1:375 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-6936
Mailing Address - Country:US
Mailing Address - Phone:802-254-8222
Mailing Address - Fax:802-254-5577
Practice Address - Street 1:375 CANAL ST
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-6936
Practice Address - Country:US
Practice Address - Phone:802-254-8222
Practice Address - Fax:802-254-5577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042.0008789174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTORE2697Medicaid
VTVN3184Medicare UPIN