Individual
MRS. CARLA TRINA VITEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10 MONTGOMERY HTS, MONTGOMERY, NY 12549-2500
(845) 457-3805
Mailing address
10 MONTGOMERY HTS, MONTGOMERY, NY 12549-2500
(845) 457-3805
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
005858-1
NY
Other
Enumeration date
11/23/2011
Last updated
11/23/2011
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