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Individual

THERESA VERTULLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Contact information

Practice address
155 EAST WOODSIDE AVENUE, PATCHOGUE, NY 11772
(631) 758-6565
(631) 758-6568
Mailing address
155 E WOODSIDE AVE, PATCHOGUE, NY 11772-1423
(631) 375-8486

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F382155-1
NY

Other

Enumeration date
02/02/2011
Last updated
03/26/2012
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