Sally A Macfadyen, IBCLC
Individual provider Active NPI Specialist · Burlington, VT
NPI 1720248255 · NPPES record last updated Jun 9, 2008
Key facts
- NPI
- 1720248255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 10117434 (VT)
- Practice address
- 15 Ludwig Court
Burlington, VT 05401-4163 - Phone
- (802) 865-2562
- NPI assigned
- Jun 9, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10117434 | VT | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 10117434 | VT | Yes |
Addresses
Primary practice location
15 Ludwig Court
Burlington, VT 05401-4163
Mailing address
15 Ludwig CT
Burlington, VT 05401-4163
Phone (802) 865-2562
Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.