Individual
MRS. KELLY M VITALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
3959 BROADWAY, NEW YORK, NY 10032-1559
(212) 342-8530
Mailing address
46 ACADEMY CIR, OAKLAND, NJ 07436-2651
(201) 638-4389
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
F381656
NY
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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