Individual
JOHN S VITELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6362
Mailing address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6362
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD08534
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-03704
UNITED HEALTHCARE
RI
01
—
1093831646
BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE
RI
01
—
1104801349
BUTLER HOSPITAL NPI
RI
01
—
119023709
MEDICARE ID-TYPE UNSPECIFIED
RI
01
—
20333-3
BLUE CROSS
RI
01
—
22860-8
BCBS - MIRIAM
RI
01
—
408074
BLUE CHIP
RI
05
—
7008653
—
RI
01
—
P00434711
MEDICARE RAILRAOD
RI
Enumeration date
01/09/2006
Last updated
08/30/2024
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