Provider Demographics
NPI:1033472402
Name:VITUCCI, DORENE
Entity Type:Individual
Prefix:
First Name:DORENE
Middle Name:
Last Name:VITUCCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DORENE
Other - Middle Name:
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:121 SHENANDOAH RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6604
Mailing Address - Country:US
Mailing Address - Phone:845-227-3640
Mailing Address - Fax:845-227-3640
Practice Address - Street 1:121 SHENANDOAH RD
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-6604
Practice Address - Country:US
Practice Address - Phone:845-227-3640
Practice Address - Fax:845-227-3640
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator