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Individual

KATHRYN LEOPOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1775 WILLISTON RD STE 110, SOUTH BURLINGTON, VT 05403-6491
(802) 735-1252
Mailing address
1775 WILLISTON RD STE 110, SOUTH BURLINGTON, VT 05403-6491
(802) 735-1252

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
207916-3
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000405203007
BLUE SHIELD
NY
05
01766343
NY
01
040426007730
FIDELIS
NY
01
10022036
CDPHP
NY
01
391213
MVP
NY
01
557E61
BLUE CROSS
NY
Enumeration date
06/10/2005
Last updated
07/30/2024
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