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NPI Code Detail

MEDICARE: SOUZANA OBRETENOVA M.D.

MEDICARE: SOUZANA OBRETENOVA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology Physician321247NY
22084N0400XNeurology Physician042.0016750VT
32084N0400XNeurology Physician280155MA
42084N0400XNeurology Physician2018004028MO

General Provider Information

NPI Number : 1144634791
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOUZANA OBRETENOVA M.D.
Provider Business Mailing Address
First Line : 111 COLCHESTER AVE
Second Line :
City : BURLINGTON
State : VT
Zip : 05401-1473
Country : US
Telephone Number : 802-847-0000
Fax Number :
Provider Business Practice Location Address
First Line : 111 COLCHESTER AVE
Second Line :
City : BURLINGTON
State : VT
Zip : 05401-1473
Country : US
Telephone Number : 802-847-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2014
Last Update Date : 02/05/2026

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Directions to “ SOUZANA OBRETENOVA M.D.” Practice Location

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