Individual
JILLIAN P VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
119 BELMONT ST, WORCESTER, MA 01605-2903
(508) 334-6206
(508) 334-6083
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4261
CT
363A00000X
Physician Assistant
Primary
PA6619
MA
Other
Enumeration date
06/19/2018
Last updated
09/23/2022
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