| Organization Name: | CHAMPLAIN VALLEY FOOT & ANKLE, P.C. |
| NPI Number: | 1366528259 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHEN JOHN MERENA (PRESIDENT) |
| Mailing Address: | 55 Main St Ste 1 Essex Junction |
| State: | VT US |
| Postal Code: | 054523191 |
| Phone Number: | 8028797992 |
| Fax Number: | 8028796969 |
| NPI Enumeration Date: | 10/31/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | 056-0000174 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |