Healthcare Provider Details

I. General information

NPI: 1710170725
Provider Name (Legal Business Name): LEONARD TREMBLAY, MD PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 06/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 FAIRFAX RD
SAINT ALBANS VT
05478-4405
US

IV. Provider business mailing address

53 FAIRFAX RD
SAINT ALBANS VT
05478-4405
US

V. Phone/Fax

Practice location:
  • Phone: 802-524-3215
  • Fax: 802-442-4778
Mailing address:
  • Phone: 802-524-3215
  • Fax: 802-442-4778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LEONARD TREMBLAY
Title or Position: CHIEF ADMINISTRATOR
Credential: MD
Phone: 802-524-3215