OrganizationActive
Lake Champlain Gynecologic Oncology, PC
NPI 1164418455 · Gynecologic Oncology Physician · South Burlington, VT
Provider details
- NPI number
- 1164418455
- Entity type
- Organization
- Primary specialty
- Gynecologic Oncology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Gamal Eltabbakh, President(802) 859-9500
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1060 Hinesburg Rd
Suite 301
South Burlington, VT 05403-7612
Phone: (802) 859-9500
Fax: (802) 859-9944
Approximate (ZIP-level) locationGet directions
Mailing address
1060 Hinesburg Rd
South Burlington, VT 05403-7612
Registry dates
- Enumerated
- 2005-09-22
- Last updated
- 2013-05-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.