Mello, Timothy J

Mello, Timothy J is an individual health care provider with primary practice located at 29 Ridgewood Rd , Springfield VT 05156-3050. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Mello, Timothy J can be contacted via phone (802) 885-6373.

Contact Information

Primary practice address
29 Ridgewood Rd Springfield VT 05156-3050
Phone: (802) 885-6373
Fax: (802) 885-6376
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0550030562 Vermont
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0416P New Hampshire
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 0550030562 Vermont
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 0416P New Hampshire

Profile Details

NPI number 1093726366
LBN Legal business name Mello, Timothy J
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2006
Last updated Feb 28th, 2008 - about 17 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 1093726366 NPPES
Vermont Other 58641 BLUECROSS
Vermont Other 341729 BLUECROSS
Vermont Other 228223 BLUECROSS
Vermont MEDICAID VN1017 BLUECROSS
Vermont MEDICAID 30334363 BLUECROSS

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