Lake Champlain Gynecologic Oncology, Pc

LBN: Lake Champlain Gynecologic Oncology, Pc
Lake Champlain Gynecologic Oncology, Pc is an health care organization with primary practice located at 1060 Hinesburg Rd Suite 301, South Burlington VT 05403-7612. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecologic Oncology, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Gynecologic Oncology is the primary health care specialty. Lake Champlain Gynecologic Oncology, Pc can be contacted via phone (802) 859-9500, or through Eltabbakh, Gamal H via phone (802) 859-9500.

Contact Information

Primary practice address
1060 Hinesburg Rd Suite 301 South Burlington VT 05403-7612
Phone: (802) 859-9500
Fax: (802) 859-9944
Website:
Map and Directions
Authorized official contact:
Name: Eltabbakh, Gamal H Doctor of Medicine (MD)
Phone: (802) 859-9500

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecologic Oncology 207VX0201X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1164418455
LBN Legal business name Lake Champlain Gynecologic Oncology, Pc
DBA Doing business as
Authorized official Eltabbakh, Gamal H Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 22nd, 2005
Last updated May 23rd, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164418455 NPPES
New York MEDICAID 01760585
New York MEDICAID 1008935

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