Healthcare Provider Details

I. General information

NPI: 1659202554
Provider Name (Legal Business Name): JOSEPH THOMAS BIELAMOWICZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 RIDGEWOOD RD
SPRINGFIELD VT
05156-3057
US

IV. Provider business mailing address

655 S WILLOW ST STE 128
MANCHESTER NH
03103-5723
US

V. Phone/Fax

Practice location:
  • Phone: 802-885-2151
  • Fax:
Mailing address:
  • Phone: 603-681-9246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number903376
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: