Basic Information
Provider Information
NPI: 1548271414
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: CHRISTINE
MiddleName: HAAS
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 49 CLIFF ST
Address2:  
City: BURLINGTON
State: VT
PostalCode: 054014506
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 111 COLCHESTER AVE
Address2: LEVEL 5 EAST PAVILION
City: BURLINGTON
State: VT
PostalCode: 054011473
CountryCode: US
TelephoneNumber: 8028474574
FaxNumber: 8028479695
Other Information
ProviderEnumerationDate: 08/10/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RR0500X0420010333VTY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology
207RR0500X2233581NYN Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

ID Information
IDTypeStateIssuerDescription
100839505VT MEDICAID
0221093305NY MEDICAID


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