Healthcare Provider Details

I. General information

NPI: 1265991269
Provider Name (Legal Business Name): ALZIRA ROCHETEAU MONTEIRO AVELINO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

89 BEAUMONT AVE
BURLINGTON VT
05405-1742
US

V. Phone/Fax

Practice location:
  • Phone: 802-656-5465
  • Fax:
Mailing address:
  • Phone: 802-656-5465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number64129
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number042.0018427
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: