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General NPI Number Information
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NPI Number | 1629039896
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Entity Type | Individual
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Provider Name | VALERIE J VITALE M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 349 MONROE ST
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City | BROOKLYN
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State | NY
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Zip | 11221-1104
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Country | US
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Telephone | 860-597-1525
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 778
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City | WELLS
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State | VT
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Zip | 05774-0778
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Country | US
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Telephone | 860-597-1525
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 177739-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 177739-01
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License Number State | NY
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