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General NPI Number Information
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NPI Number | 1144247834
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Entity Type | Individual
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Provider Name | ANNE VITALETTI-COUGHLIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 530 WASHINGTON HWY POB SUITE 1
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City | MORRISVILLE
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State | VT
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Zip | 05661-8715
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Country | US
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Telephone | 802-888-8392
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Fax | 802-888-5536
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Provider Business Mailing Address
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Address Line | 347 UPPER HOLLOW RD
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City | STOWE
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State | VT
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Zip | 05672-4520
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Country | US
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Telephone | 802-253-8735
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 0420008983
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License Number State | VT
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