Provider Demographics
NPI:1407004161
Name:VITETTA, CATHERINE MARY (PT)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:MARY
Last Name:VITETTA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:778 COUNTY ROUTE 7
Mailing Address - Street 2:
Mailing Address - City:EAST SCHODACK
Mailing Address - State:NY
Mailing Address - Zip Code:12063
Mailing Address - Country:US
Mailing Address - Phone:518-729-4521
Mailing Address - Fax:
Practice Address - Street 1:778 COUNTY ROUTE 7
Practice Address - Street 2:
Practice Address - City:EAST SCHODACK
Practice Address - State:NY
Practice Address - Zip Code:12063
Practice Address - Country:US
Practice Address - Phone:518-729-4521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006762-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist