Healthcare Provider Details

I. General information

NPI: 1447922059
Provider Name (Legal Business Name): SYDNEY FERRELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

111 COLCHESTER AVE
BURLINGTON VT
05401-1473
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-7911
  • Fax: 802-847-5784
Mailing address:
  • Phone: 802-847-7911
  • Fax: 802-847-5784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number032.0134317
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: