Provider Demographics
NPI:1265713986
Name:VITALETTI, M. CHERYL (RN)
Entity type:Individual
Prefix:
First Name:M. CHERYL
Middle Name:
Last Name:VITALETTI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2395
Mailing Address - Country:US
Mailing Address - Phone:315-435-4145
Mailing Address - Fax:315-435-4859
Practice Address - Street 1:725 HARRISON ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2395
Practice Address - Country:US
Practice Address - Phone:315-435-4145
Practice Address - Fax:315-435-4859
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301458-1163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator