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Individual

TOMAS T. ENSALATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
8 COMMONS ST, RUTLAND, VT 05701-4651
(802) 770-1805
Mailing address
1057 MAPLE ST, VERGENNES, VT 05491-8527
(802) 233-1447

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
055.0031731
VT

Other

Enumeration date
12/07/2023
Last updated
12/14/2023
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