Provider Demographics
NPI:1285000158
Name:SANO, GREGORY
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:
Last Name:SANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 WILLISTON RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6069
Mailing Address - Country:US
Mailing Address - Phone:802-651-9626
Mailing Address - Fax:802-651-9790
Practice Address - Street 1:1860 WILLISTON RD
Practice Address - Street 2:SUITE 5
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6069
Practice Address - Country:US
Practice Address - Phone:802-651-9626
Practice Address - Fax:802-651-9790
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT102814237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist