Provider Demographics
NPI:1669735114
Name:BAZARSKY, ALLYSON BETH (DO)
Entity type:Individual
Prefix:DR
First Name:ALLYSON
Middle Name:BETH
Last Name:BAZARSKY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 COLCHESTER AVENUE
Mailing Address - Street 2:UVM MEDICAL CENTER NEUROLOGY
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401
Mailing Address - Country:US
Mailing Address - Phone:802-862-5759
Mailing Address - Fax:802-658-0680
Practice Address - Street 1:111 COLCHESTER AVENUE
Practice Address - Street 2:UVM MEDICAL CENTER NEUROLOGY
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401
Practice Address - Country:US
Practice Address - Phone:802-862-5759
Practice Address - Fax:802-658-0680
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2017-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34.0123262084N0400X
SCLL15862084N0400X
VT032-01294672084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1033045Medicaid