Individual provider · NPI-1

Erica J Gibson, MD

Pediatrics, Adolescent Medicine · Burlington, VT

NPI number1720158934
StatusActive
Last updated in NPPESJun 5, 2014

Details

NPI
1720158934
Entity type
Individual (NPI-1)
Name
Erica J Gibson
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Nov 8, 2006
Last updated
Jun 5, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2080A0000X Pediatrics, Adolescent Medicine0420012903VTYes
208000000X Pediatrics231907NY

Practice location

1 S Prospect St
3rd Floor
Burlington, VT 05401-3456

Phone 802-847-4696 · Fax 802-847-8207

Mailing address

1 S Prospect St
3rd Floor
Burlington, VT 05401-3456

Phone 802-847-4696 · Fax 802-847-8207

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