Healthcare Provider Details

I. General information

NPI: 1982627691
Provider Name (Legal Business Name): STEPHEN CONTOMPASIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 10/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

1 SOUTH PROSPECT ST. REHAB 4318
BURLINGTON VT
05401
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-8200
  • Fax: 802-847-8742
Mailing address:
  • Phone: 802-864-4696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0420008397
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number0420008397
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License Number0420008397
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: