Individual
MR. KENNETH J VITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7580 AUBURN ROAD, #103, PAINESVILLE, OH 44077
(440) 352-1474
(440) 352-2662
Mailing address
7580 AUBURN ROAD, #103, PAINESVILLE, OH 44077
(440) 352-1474
(440) 352-2662
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
35-069985
OH
207Y00000X
Otolaryngology Physician
Primary
35-069985
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000133450
ANTHEM
OH
05
—
0244533
—
OH
01
—
040013864
TRAVELERS RAILROAD MEDICA
OH
01
—
104635
KAISER
OH
01
—
3415313198A14
BCBS
OH
01
—
54721
QUALCHOICE
OH
Enumeration date
01/25/2006
Last updated
02/16/2010
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