| Doctor Name: | MS. EMILY ROSE KAVOUKSORIAN |
| NPI Number: | 1174549745 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.A. - C |
| License Number: | 055-0030783 |
| Business Practice Address: | 354 Mountain View Dr Suite 103 Colchester, VT - 054465968 |
| Business Phone Number: | 8028473340 |
| Business Fax Number: | 8028472539 |
| Mailing Address: | 24 Bayberry Ln, SOUTH BURLINGTON |
| State: | VT |
| Postal Code: | 054038205 |
| Phone Number: | 8022364706 |
| Fax Number: | |
| NPI Enumeration Date: | 07/15/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 055-0030783 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |