1891013793 NPI number — LAMOILLE HEALTH PARTNERS, INC

Table of content: OMAR MAHMUD SIDDIQI M.D (NPI 1861750069)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891013793 NPI number — LAMOILLE HEALTH PARTNERS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAMOILLE HEALTH PARTNERS, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LAMOILLE HEALTH FAMILY DENTISTRY
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891013793
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 749
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORRISVILLE
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05661-0749
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-851-8600
Provider Business Mailing Address Fax Number:
802-851-8313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
66 MORRISVILLE PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORRISVILLE
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05661-4482
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-888-7585
Provider Business Practice Location Address Fax Number:
802-851-8313
Provider Enumeration Date:
05/17/2010

Additional Information

Authorized Official

Authorized Official Last Name:
MAY
Authorized Official First Name:
STUART
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
802-888-0901

Provider Taxonomy Codes

  • Taxonomy code: 122300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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