Provider Demographics
NPI:1821651837
Name:ASSUNTA VITTI, PHD
Entity Type:Organization
Organization Name:ASSUNTA VITTI, PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ASSUNTA
Authorized Official - Middle Name:
Authorized Official - Last Name:VITTI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:845-243-0175
Mailing Address - Street 1:514 HUDSON VIEW RD
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-1121
Mailing Address - Country:US
Mailing Address - Phone:516-697-4185
Mailing Address - Fax:
Practice Address - Street 1:48 BURD ST STE 306
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3257
Practice Address - Country:US
Practice Address - Phone:845-243-0175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-16
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY017430-1OtherNY STATE OFFICE OF PROFESSIONS
NYLICENSEOtherLICENSE