Healthcare Provider Details

I. General information

NPI: 1326212804
Provider Name (Legal Business Name): MOUNTAIN VIEW BREAST CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 WILLISTON RD STE 108
S BURLINGTON VT
05403-6491
US

IV. Provider business mailing address

1775 WILLISTON RD STE 108
S BURLINGTON VT
05403-6491
US

V. Phone/Fax

Practice location:
  • Phone: 802-497-3370
  • Fax: 802-497-3370
Mailing address:
  • Phone: 802-497-3370
  • Fax: 802-497-0816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateVT

VIII. Authorized Official

Name: JULIE A ALOSI
Title or Position: ADMINISTRATOR
Credential: MD
Phone: 802-497-3370