Provider Demographics
NPI:1982967766
Name:VITARELLI, MELISSA F (MS ED, BCBA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:F
Last Name:VITARELLI
Suffix:
Gender:F
Credentials:MS ED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OLD FIELD LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-1410
Mailing Address - Country:US
Mailing Address - Phone:516-242-6186
Mailing Address - Fax:
Practice Address - Street 1:2 OLD FIELD LN
Practice Address - Street 2:
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-1410
Practice Address - Country:US
Practice Address - Phone:516-242-6186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5134174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist