Provider Demographics
NPI:1699857920
Name:CERRA-BELLINGHIRI, JANINE (PT)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:CERRA-BELLINGHIRI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 571
Mailing Address - Street 2:
Mailing Address - City:SOUTH HERO
Mailing Address - State:VT
Mailing Address - Zip Code:05486-0571
Mailing Address - Country:US
Mailing Address - Phone:802-372-4412
Mailing Address - Fax:
Practice Address - Street 1:323 ROUTE 2
Practice Address - Street 2:
Practice Address - City:SOUTH HERO
Practice Address - State:VT
Practice Address - Zip Code:05486-4213
Practice Address - Country:US
Practice Address - Phone:802-372-4412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0400002502225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT43V021OtherMVP
VT00008884OtherBCBS
VT272925OtherCIGNA
VT030281196005OtherTRICARE
VT1007593Medicaid