Provider Demographics
NPI:1780908343
Name:CANGIANO, MICHELLE LISA (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LISA
Last Name:CANGIANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:HINESBURG
Mailing Address - State:VT
Mailing Address - Zip Code:05461-9303
Mailing Address - Country:US
Mailing Address - Phone:802-847-7400
Mailing Address - Fax:
Practice Address - Street 1:22 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:HINESBURG
Practice Address - State:VT
Practice Address - Zip Code:05461-9303
Practice Address - Country:US
Practice Address - Phone:802-847-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042.0012674207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine