NPI 1720021918 · live from the CMS NPI Registry
Marjorie Nikki Gewirz, PA-C
Physician Assistant in Randolph, VT. National Provider Identifier 1720021918, active.
NPI record
| NPI | 1720021918 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 44 S Main St, Surgical Associates, Randolph, VT 05060 |
| Practice phone | 802-728-2372 |
| Enumerated | June 14, 2006 |
| Last updated | October 30, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Surgical | 363AS0400X | 0581 (NH) |
| Physician Assistant, Surgical | 363AS0400X | 055-0031029 (VT) |
| Physician Assistant, Surgical | 363AS0400X | 055-0030993 (VT) |
| Physician Assistant primary | 363A00000X | 055-0030993 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.