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Individual
NICOLE M VITALE
Active
Individual
NICOLE M VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
016555-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7255424
AETNA
—
01
—
7702294
MVP
—
01
—
RC62016555
RICPA
—
Enumeration date
02/20/2007
Last updated
07/08/2007
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