Provider Demographics
NPI:1427075290
Name:GELBSTEIN, JENNIFER B (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:B
Last Name:GELBSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:CENTRAL VERMONT MEDICAL CENTER - FINANCE DEPT
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-0547
Mailing Address - Country:US
Mailing Address - Phone:802-244-7874
Mailing Address - Fax:802-244-4106
Practice Address - Street 1:130 S MAIN ST
Practice Address - Street 2:WATERBURY MEDICAL ASSOCIATES
Practice Address - City:WATERBURY
Practice Address - State:VT
Practice Address - Zip Code:05676-1519
Practice Address - Country:US
Practice Address - Phone:802-244-7874
Practice Address - Fax:802-244-4106
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT042-0009948207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN2486Medicaid
NH3091431Medicaid
H16362Medicare UPIN
NH3091431Medicaid