Individual
CHARLENE MARY VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
221 N SUNRISE SERVICE RD, MANORVILLE, NY 11949-9604
(631) 878-8900
(631) 878-8962
Mailing address
221 N SUNRISE SERVICE RD, MANORVILLE, NY 11949-9604
(631) 878-8900
(631) 878-8962
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001099-1
NY
Other
Enumeration date
03/02/2016
Last updated
03/02/2016
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