Mello, Timothy J
Mello, Timothy J is an individual health care provider with primary practice located at 29 Ridgewood Rd , Springfield VT 05156-3050. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Mello, Timothy J can be contacted via phone (802) 885-6373.Contact Information
Primary practice address
29 Ridgewood Rd
Springfield VT 05156-3050
Phone: (802) 885-6373
Fax: (802) 885-6376
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 0550030562 | Vermont |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 0416P | New Hampshire |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 0550030562 | Vermont |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 0416P | New Hampshire |
Profile Details
| NPI number | 1093726366 |
|---|---|
| LBN Legal business name | Mello, Timothy J |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 11th, 2006 |
| Last updated | Feb 28th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093726366 | NPPES |
| Vermont | Other | 58641 | BLUECROSS |
| Vermont | Other | 341729 | BLUECROSS |
| Vermont | Other | 228223 | BLUECROSS |
| Vermont | MEDICAID | VN1017 | BLUECROSS |
| Vermont | MEDICAID | 30334363 | BLUECROSS |
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