Provider Demographics
NPI:1891568283
Name:VITALE, CHRISTINE M (MS)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:VITALE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ORBIT LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-7716
Mailing Address - Country:US
Mailing Address - Phone:347-439-3162
Mailing Address - Fax:
Practice Address - Street 1:44 COURT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4405
Practice Address - Country:US
Practice Address - Phone:347-439-3162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty