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VITALY VAVRINYUK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
300 WEST AVE, ITHACA, NY 14853-6002
(607) 254-4636
Mailing address
121 VETERANS PL UNIT E-104, ITHACA, NY 14850-6900
(253) 306-2691

Taxonomy

Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
746036
NY

Other

Enumeration date
10/02/2020
Last updated
10/02/2020
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