Healthcare Provider Details

I. General information

NPI: 1417066341
Provider Name (Legal Business Name): CARINA CARTELLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 SAN REMO DR STE 202
SOUTH BURLINGTON VT
05403-6386
US

IV. Provider business mailing address

102 S WINOOSKI AVE
BURLINGTON VT
05401-7406
US

V. Phone/Fax

Practice location:
  • Phone: 802-488-6000
  • Fax: 802-488-6919
Mailing address:
  • Phone: 802-488-6920
  • Fax: 802-488-6919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number042-0011058
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number042-0011058
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: