MEDICARE: JOSEPH A MESSINA MD

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
1	2084P0800X	Psychiatry Physician	042-0010707	VT

General Provider Information

NPI Number	:	1255325601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH A MESSINA MD

Provider Business Mailing Address
First Line	:	1 S PROSPECT ST
Second Line	:
City	:	BURLINGTON
State	:	VT
Zip	:	05401-3456
Country	:	US
Telephone Number	:	802-847-4104
Fax Number	:	802-847-3326

Provider Business Practice Location Address
First Line	:	1 S PROSPECT ST
Second Line	:
City	:	BURLINGTON
State	:	VT
Zip	:	05401-3456
Country	:	US
Telephone Number	:	802-847-4104
Fax Number	:	802-847-3326

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	10/29/2014

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