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Individual

DR. VICTOR J PISANELLI JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
241 STRATTON RD, RUTLAND, VT 05701-4621
(802) 775-1903
Mailing address
160 ALLEN ST, RUTLAND, VT 05701-4560
(802) 775-1904

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
42-0005978
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0004711
VT
Enumeration date
07/16/2006
Last updated
05/23/2011
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