Individual
MRS. VIVIAN M CALOBRISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
41 MEDICAL VILLAGE DR, NEWPORT, VT 05855-9835
(802) 334-3504
(802) 334-3512
Mailing address
41 MEDICAL VILLAGE DR, NEWPORT, VT 05855-9835
(802) 334-3504
(802) 334-3512
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0550030279
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002510
—
VT
01
—
00028004
BLUE SHIELD
VT
01
—
118505
MVP
VT
01
—
8000219
LADIES FIRST
VT
01
—
P00055182
RAILROAD MEDICARE
VT
Enumeration date
11/01/2006
Last updated
06/16/2009
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