Provider Demographics
NPI:1265052328
Name:BARTORILLO, VIPAVEE
Entity type:Individual
Prefix:MRS
First Name:VIPAVEE
Middle Name:
Last Name:BARTORILLO
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 1:5309 PATUXENT DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-6568
Mailing Address - Country:US
Mailing Address - Phone:919-539-4715
Mailing Address - Fax:
Practice Address - Street 1:5309 PATUXENT DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-6568
Practice Address - Country:US
Practice Address - Phone:919-539-4715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-19
Last Update Date:2020-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12705224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant