Basic Information
| Provider Information | |||||||||
| NPI: | 1750525192 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLYER | ||||||||
| FirstName: | JONATHAN | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1063 | ||||||||
| Address2: | UVM MEDICAL CENTER | ||||||||
| City: | BURLINGTON | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054021063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8028470000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 111 COLCHESTER AVENUE | ||||||||
| Address2: | UNIVERSITY OF VERMONT MEDICAL CENTER | ||||||||
| City: | BURLINGTON | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054011573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8028470000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2009 | ||||||||
| LastUpdateDate: | 08/04/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 050556 | CT | Y | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 278442 | NY | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0202X | 042-0013411 | VT | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology |
No ID Information.