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LAKE CHAMPLAIN GYNECOLOGIC ONCOLOGY, PC
NPI 1164418455
Obstetrics & Gynecology - Gynecologic Oncology in South Burlington, VT

Active since September 22, 2005
1060 HINESBURG RD, SUITE 301, SOUTH BURLINGTON, VT 05403(802) 859-9500(802) 859-9944 Get Directions Write a Review

NPPES record last updated: May 23, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Lake Champlain Gynecologic Oncology, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE CHAMPLAIN GYNECOLOGIC ONCOLOGY, PC (NPI 1164418455) is a healthcare organization registered as a gynecologic oncology in South Burlington, Vermont and active in the NPI registry since September 2005. The organization lists Gamal H Eltabbakh, President, as its authorized official.

NPPES Registry Identity

NPI1164418455
Entity TypeOrganization
Primary Taxonomy207VX0201X
Legal Business NameLAKE CHAMPLAIN GYNECOLOGIC ONCOLOGY, PC
Location Address1060 HINESBURG RD, SUITE 301South Burlington, VT 05403-7612
Mailing Address1060 Hinesburg Rd, Suite 301South Burlington, VT 05403-7612 · (802) 859-9500 · Fax (802) 859-9944
Phone(802) 859-9500
Fax(802) 859-9944
Organization SubpartNo
Authorized OfficialGamal H EltabbakhPresident · (802) 859-9500
Enumeration DateSeptember 22, 2005
Last NPPES UpdateMay 23, 2013
✔ NPI 1164418455 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyObstetrics & Gynecology · Gynecologic OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207VX0201X
Definition
An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
1060 HINESBURG RD, South Burlington, VT 05403
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Other Identifiers 4

Medicare PINAA1688NY
Medicaid1008935VT
Medicaid01760585NY
Medicare PINVN2936VT

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

UNIVERSITY OF VERMONT MEDICAL CENTER
Dentist (General Practice)
1060 HINESBURG RD, SUITE 202
SOUTH BURLINGTON, VT 05403
Chittenden County (802) 847-1777
DR. GAMAL H ELTABBAKH M.D.
Obstetrics & Gynecology (Gynecologic Oncology)
1060 HINESBURG RD, SUITE 301
SOUTH BURLINGTON, VT 05403
Chittenden County (802) 859-9500
ANGELA DUNKLING
Dentist
1060 HINESBURG RD, SUITE 201
SOUTH BURLINGTON, VT 05403
Chittenden County (802) 847-2700
GEORGIA D ELTABBAKH P.A.
Physician Assistant (Medical)
1060 HINESBURG RD, SUITE 301
SOUTH BURLINGTON, VT 05403
Chittenden County (802) 859-9500
DR. JANET THOMASON MICCOLO D.D.S.
Dentist (General Practice)
1060 HINESBURG RD, SUITE 201
SOUTH BURLINGTON, VT 05403
Chittenden County (802) 847-1777

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Champlain Gynecologic Oncology, PC's NPI number?

The NPI number for Lake Champlain Gynecologic Oncology, PC is 1164418455. It was assigned to this organization in the NPPES registry on September 22, 2005.

Where is Lake Champlain Gynecologic Oncology, PC located?

Lake Champlain Gynecologic Oncology, PC is located at 1060 Hinesburg Rd Suite 301, South Burlington, VT 05403. The listed phone number is (802) 859-9500.

What is Lake Champlain Gynecologic Oncology, PC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecologic Oncology, with taxonomy code 207VX0201X.

When was this NPI record last updated?

The NPPES record for Lake Champlain Gynecologic Oncology, PC was last updated on May 23, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.