Organization
FEDERAL HILL OTOLARYNGOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE J VITALE MD (PRESIDENT)
(860) 583-1845
Entity
Organization
Contact information
Practice address
291 QUEEN ST, BRISTOL, CT 06010-6379
(860) 583-1845
Mailing address
291 QUEEN ST, BRISTOL, CT 06010-6379
(860) 583-1845
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
033390
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010033390CT
ANTHEM
CT
01
—
0271873004
CIGNA
CT
01
—
033390
CONNECTICARE
CT
01
—
HAS 077
OXFORD
CT
Enumeration date
06/17/2006
Last updated
08/22/2020
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