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Individual

MR. STEPHEN DAVID VITALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
11110 JAMAICA AVE, RICHMOND HILL, NY 11418-2322
(718) 847-2688
(718) 847-2627
Mailing address
58 BUCKINGHAM PL, LYNBROOK, NY 11563-1835
(516) 599-4475
(516) 599-2185

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006447
NY

Other

Enumeration date
08/30/2006
Last updated
08/18/2007
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