# CHAMPLAIN VALLEY ANESTHESIA PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871890228
- **Authorized official:** KEVIN L IANNI MD (AUTHORIZED REPRESENTATIVE)
- **Authorized official phone:** (802) 462-3225

## Contact information

- **Practice address:** 115 PORTER DR, MIDDLEBURY, VT 05753-8423
- **Practice address phone:** (802) 388-4724
- **Mailing address:** 519 ROBBINS RD, CORNWALL, VT 05753-9236
- **Mailing address phone:** (802) 462-3225

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/22/2011
- **Last updated:** 02/22/2011