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General NPI Number Information
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NPI Number | 1730779653
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Entity Type | Individual
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Provider Name | BRYAN FELITTO
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Gender | Male
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 49 WRIGHT AVE
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City | WILLISTON
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State | VT
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Zip | 05495-4419
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Country | US
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Telephone | 802-872-8840
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Fax |
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Provider Business Mailing Address
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Address Line | 42 N PROSPECT ST APT 6
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City | BURLINGTON
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State | VT
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Zip | 05401-3340
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Country | US
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Telephone | 917-309-5376
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 033.0134325
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License Number State | VT
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