Individual
MS. MIRIAM VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
950 CAMPBELL AVE, PSYCH PRIMARY CARE, WEST HAVEN, CT 06516-2770
(203) 932-5711
Mailing address
950 CAMPBELL AVE, PSYCH PRIMARY CARE, WEST HAVEN, CT 06516-2770
(203) 932-5711
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000691
CT
Other
Enumeration date
03/10/2006
Last updated
10/01/2007
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