Provider Demographics
NPI:1508300401
Name:RENDA-VITALE, FRANCESCA ANTONELLA
Entity Type:Individual
Prefix:
First Name:FRANCESCA
Middle Name:ANTONELLA
Last Name:RENDA-VITALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25212 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-2728
Mailing Address - Country:US
Mailing Address - Phone:718-831-4027
Mailing Address - Fax:
Practice Address - Street 1:25212 72ND AVE
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-2728
Practice Address - Country:US
Practice Address - Phone:718-831-4027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014785235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist