Healthcare Provider Details

I. General information

NPI: 1366689929
Provider Name (Legal Business Name): BENEDETTO VITIELLO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2009
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 WISCONSIN AVE NW STE 400
WASHINGTON DC
20015-2055
US

IV. Provider business mailing address

5801 MIDHILL ST
BETHESDA MD
20817-6138
US

V. Phone/Fax

Practice location:
  • Phone: 202-363-1010
  • Fax:
Mailing address:
  • Phone: 240-234-1621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD39092
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD19117
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: