Individual provider · NPI-1

Stephanie Cowan Bellomo, md

Family Medicine · Burlington, VT

NPI number1295709350
StatusActive
Last updated in NPPESMar 2, 2016

Details

NPI
1295709350
Entity type
Individual (NPI-1)
Name
Stephanie Cowan Bellomo
Credential
md
Sex
Female
Sole proprietor
No
Enumeration date
Feb 15, 2006
Last updated
Mar 2, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine042-0007552VTYes

Practice location

789 Pine St
Burlington, VT 05401-4933

Phone 802-864-0693 · Fax 802-860-6613

Mailing address

617 Riverside Ave
Suite 190
Burlington, VT 05401-1601

Phone 802-864-6309 · Fax 802-860-4313

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