Individual
MR. JOSEPH ANDREW VITAGLIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1110 E MISSOURI AVE STE 110, PHOENIX, AZ 85014-2703
(480) 542-8202
Mailing address
4279 E TETHER TRL, PHOENIX, AZ 85050-8949
(480) 212-6408
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5483
AZ
363AM0700X
Medical Physician Assistant
5483
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003242447
PSYCHIATRY
—
Enumeration date
09/17/2013
Last updated
04/07/2022
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