Doctor Name: | PATRICK HEANEY |
NPI Number: | 1174626089 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA/C |
License Number: | 055-0030775 |
Business Practice Address: | 30 East St Orleans Medical Clinic Orleans, VT - 05860 |
Business Phone Number: | 8027542220 |
Business Fax Number: | 8027542195 |
Mailing Address: | 61 Home St, BERLIN |
State: | NH |
Postal Code: | 03570 |
Phone Number: | 6037529252 |
Fax Number: | |
NPI Enumeration Date: | 09/06/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 055-0030775 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |