MEDICARE: CHRISTINE VITERI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1417725094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE VITERI

Provider Business Mailing Address
First Line	:	4262 157TH ST APT C5
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11355-1138
Country	:	US
Telephone Number	:	917-587-1944
Fax Number	:

Provider Business Practice Location Address
First Line	:	4262 157TH ST APT C5
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11355-1138
Country	:	US
Telephone Number	:	917-587-1944
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2023
Last Update Date	:	12/13/2023

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Directions to “ CHRISTINE VITERI ” Practice Location

Language	Start Address	Practice Location

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