Individual
GEORGIA D ELTABBAKH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1060 HINESBURG RD, SUITE 301, SOUTH BURLINGTON, VT 05403-7612
(802) 859-9500
(802) 859-9944
Mailing address
1060 HINESBURG RD, SUITE 301, SOUTH BURLINGTON, VT 05403-7612
(802) 859-9500
(802) 859-9944
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
010999
NY
363AM0700X
Medical Physician Assistant
Primary
0550030657
VT
363AS0400X
Surgical Physician Assistant
0550030657
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90000398
—
VT
Enumeration date
09/22/2005
Last updated
06/28/2013
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