Basic Information
| Provider Information | |||||||||
| NPI: | 1083679179 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZEVIAR | ||||||||
| FirstName: | MARYROSE | ||||||||
| MiddleName: | MONICA | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 260 CREST RD | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | SAINT ALBANS | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054789503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8025248952 | ||||||||
| FaxNumber: | 8025247952 | ||||||||
| Practice Location | |||||||||
| Address1: | 133 FAIRFIELD ST | ||||||||
| Address2: | EMERGENCY DEPARTMENT | ||||||||
| City: | SAINT ALBANS | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054781726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8025241037 | ||||||||
| FaxNumber: | 8025241053 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2006 | ||||||||
| LastUpdateDate: | 12/29/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 055-0030601 | VT | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.