Individual
SUSAN ANN VITALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 PLANT AVE, HAUPPAUGE, NY 11788-3805
(631) 851-3810
(631) 273-4342
Mailing address
120 PLANT AVE, HAUPPAUGE, NY 11788-3805
(631) 851-3810
(631) 273-4342
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
300786-1
NY
Other
Enumeration date
10/27/2006
Last updated
07/08/2007
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