DR. GREGORY CONNOLLY MD NPI 1366641086

NPI Information

  • NPI: 1366641086
  • Provider Name: DR. GREGORY CONNOLLY, MD
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Individual
  • Address: 128 LAKESIDE AVE
    SUITE 115
    BURLINGTON, VT
    ZIP 05401
  • Phone: (802) 860-1928

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NPI Details

DR. Gregory Connolly, MD is an adolescent medicine pediatrics in Burlington, VT. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. DR. Gregory Connolly, MD NPI is 1366641086. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

128 LAKESIDE AVE
SUITE 115
BURLINGTON, VT
ZIP 05401-939
Phone: (802) 860-1928
Fax: (802) 860-0192

The enumeration date for this NPI number is 7/12/2007 and was last updated on 10/4/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080A0000XPediatricsAdolescent Medicine042-0011956VERMONTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11017604MEDICAIDVERMONT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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