Fantelli, Kerry N

Fantelli, Kerry N is an individual health care provider with primary practice located at 617 Riverside Ave , Burlington VT 05401-1601. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Fantelli, Kerry N can be contacted via phone (802) 864-6309.

Contact Information

Primary practice address
617 Riverside Ave Burlington VT 05401-1601
Phone: (802) 864-6309
Fax: (802) 860-4324
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0550030723 Vermont

Profile Details

NPI number 1649227877
LBN Legal business name Fantelli, Kerry N
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649227877 NPPES
Vermont Other 4141802 MVP
Vermont Other 58727 MVP
Vermont MEDICAID 9000147 MVP
Vermont Other 58727 MVP

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