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Individual

TRACY VITULLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT, LAC

Contact information

Practice address
250 W 57TH ST, NEW YORK, NY 10107-0001
(631) 258-2297
Mailing address
5931 GROVE ST, RIDGEWOOD, NY 11385-2634
(631) 258-2297

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
004237
NY
225700000X
Massage Therapist
022924
NY

Other

Enumeration date
10/22/2009
Last updated
04/26/2011
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