NPI 1871589150 · live from the CMS NPI Registry
Georgia D Eltabbakh, P.A.
Physician Assistant, Medical in South Burlington, VT. National Provider Identifier 1871589150, active.
NPI record
| NPI | 1871589150 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 1060 Hinesburg Rd, Suite 301, South Burlington, VT 05403 |
| Practice phone | 802-859-9500 |
| Enumerated | September 22, 2005 |
| Last updated | June 28, 2013 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical primary | 363AM0700X | 0550030657 (VT) |
| Physician Assistant, Surgical | 363AS0400X | 0550030657 (VT) |
| Physician Assistant | 363A00000X | 010999 (NY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.