DR. SALLY HERSCHORN (NPI# 1013934835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013934835 |
| Entity Type | Individual |
| Full Name | DR. SALLY HERSCHORN |
| Credential | MD |
| Practice Address |
111 Colchester Ave Burlington VT 05401-1473 |
| Practice Telephone | 8028473592 |
| Practice Fax Number | 8028474822 |
| Mailing Telephone | 8028473592 |
| Mailing Fax Number | 8028474822 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2013-11-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
0420007509 | VT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 4756 | 05 |
| Street Address |
111 COLCHESTER AVE |
| City | BURLINGTON |
| State | VT |
| Zip Code | 05401-1473 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376548354 | Richard A. Boothby | Obstetrics & Gynecology | 111 Colchester Ave, Burlington, VT 05401-1473 | 2005-06-16 |
| 1992304513 | Jennifer Smith Henry | Registered Nurse | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-10-23 |
| 1922606581 | Jessica Fischer | Dietitian, Registered | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-10-15 |
| 1922615855 | Emily R Pichler | Psychologist | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-09-24 |
| 1285257618 | Nadia Stefania Fletcher | Registered Nurse | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-05-20 |
| 1538781380 | Jeffrey Raymond Gonzalez | Pharmacist | 111 Colchester Ave, Mailstop 272ba1, Burlington, VT 05401 | 2020-05-15 |
| 1588292874 | Breshawn Best | Student in an Organized Health Care Education/Training Program | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-03-31 |
| 1528696853 | Nektarios Konstantinopoulos | Student in an Organized Health Care Education/Training Program | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-03-31 |
| 1457989071 | Siddique Tanzeem Akram | Student in an Organized Health Care Education/Training Program | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-03-30 |
| 1184252124 | Steven Direda II | Student in an Organized Health Care Education/Training Program | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821626748 | John Henry Priester Jr. | Student in an Organized Health Care Education/Training Program | University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT 05401 | 2020-03-27 |
| 1730649054 | Parisa Heidari | Student in an Organized Health Care Education/Training Program | Uvmmc 111 Colchester Avenue, Burlington, VT 05401 | 2019-03-22 |
| 1689141988 | No Diet Dietitian, LLC | Dietitian, Registered | 163 Bayberry Circle #204, Burlington, VT 05401 | 2018-10-25 |
| 1073097267 | Katherine Dwyer | Physical Therapist | 128 Lakeside Ave, Burlington, Vt, 05401, Burlington, VT 05401 | 2018-09-24 |
| 1710469481 | Nicholas A Fredette | Nurse Practitioner | 28 S. Williams St., Burlington, VT 05401 | 2018-08-30 |
| 1760987473 | Tyler Fanning | Psychiatry & Neurology | Uvmmv 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-26 |
| 1356845416 | Rachel Carlson | Student in an Organized Health Care Education/Training Program | Uvmmc, 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-22 |
| 1487152096 | Garnet Transport Medicine, LLC | Ambulance | 70 S Winooski Ave Ste 255, Burlington, VT 05401 | 2018-01-29 |
| 1689172660 | Valerie Goldberg | Dietitian, Registered | 163 Bayberry Circle Apt 204, Burlington, VT 05401 | 2018-01-25 |
| 1548774235 | Emily R Day | Physical Therapist | 160 Flynn Avenue, Burlington, VT 05401 | 2017-11-17 |
| Find all providers in zip 05401 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457643272 | Matthew G. Geeslin | Radiology | 111 Colchester Ave Dept Of, Burlington, VT 05401-1473 | 2011-05-12 |
| 1871825281 | Gregory Day | Radiology | 2609 Bittersweet Pl, Burlington, IA 52601-2510 | 2010-02-10 |
| 1619045960 | James Howard Small | Radiology | 1017 N 4th St, Burlington, IA 52601-4804 | 2006-12-02 |
| 1790892834 | Tai M Tran | Radiology | Lahey Medical Ctr, 41 Mall Road, Burlington, MA 01805-0001 | 2006-08-24 |
| 1205846151 | Peter Hongkyun Lee | Radiology | 41 Mall Rd Lahey Hospital and Medical Ctr, Burlington, MA 01805-2961 | 2006-08-09 |
| 1467499053 | Jane C Primm | Radiology | 111 Colchester Ave, Acc-2nd Fl, Fletcher Allen Health Care, Burlington, VT 05401-1473 | 2006-06-01 |
| 1336106533 | Lisl Warren | Radiology | Lahey Clinic/radiology, 41 Mall Road, Burlington, MA 01805-0001 | 2006-05-01 |
| 1326046970 | Urvi Fulwadhva | Radiology | Lahey Clinic, Inc., 41 Mall Road, Burlington, MA 01805-0001 | 2005-07-08 |
| 1922594019 | Paschalis Toskas | Radiology | 41 Burlington Mall Road, Burlington, MA 01805 | 2018-07-02 |
| 1043763758 | Richard Thomas | Radiology | Lahey Hospital & Medical Center, 41 Mall Road, Burlington, MA 01805 | 2016-07-28 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 05401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.