Provider Demographics
NPI:1669469185
Name:CHEN-VITULLI, JEAN TSAI-PING (DPM)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:TSAI-PING
Last Name:CHEN-VITULLI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:JEAN
Other - Middle Name:TSAI-PING
Other - Last Name:VITULLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:257 STONYKILL RD
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-5459
Mailing Address - Country:US
Mailing Address - Phone:845-616-4480
Mailing Address - Fax:845-230-8625
Practice Address - Street 1:257 STONYKILL RD
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-5459
Practice Address - Country:US
Practice Address - Phone:845-616-4480
Practice Address - Fax:845-230-8625
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-29
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005897213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1881759033OtherVITULLI FOOT CARE NPI
NY02699874Medicaid
NYPJ95088801Medicare PIN
NYV05040Medicare UPIN
NY02699874Medicaid