Provider Demographics
NPI:1942717798
Name:VECCHI, GENET MICHELLE (TEACHER)
Entity Type:Individual
Prefix:
First Name:GENET
Middle Name:MICHELLE
Last Name:VECCHI
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3914 AVENUE R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4329
Mailing Address - Country:US
Mailing Address - Phone:917-517-5337
Mailing Address - Fax:
Practice Address - Street 1:3914 15TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4410
Practice Address - Country:US
Practice Address - Phone:718-853-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY740764131174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist