Connolly, Gregory
Connolly, Gregory is an individual health care provider with primary practice located at 128 Lakeside Ave Suite 115, Burlington VT 05401-4939. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Connolly, Gregory can be contacted via phone (802) 860-1928.Contact Information
Primary practice address
128 Lakeside Ave Suite 115
Burlington VT 05401-4939
Phone: (802) 860-1928
Fax: (802) 860-0192
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 042-0011956 | Vermont |
Profile Details
| NPI number | 1366641086 |
|---|---|
| LBN Legal business name | Connolly, Gregory |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2007 |
| Last updated | Oct 4th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366641086 | NPPES |
| Vermont | MEDICAID | 1017604 |
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