Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 245902 | NY |
N | 207XS0106X | Orthopaedic Hand Surgeon | 245902 | NY |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 50843 | CT |
NPI | 1013174697 |
---|---|
Provider Name | Dr. Mark Anthony Vitale |
First Address | Greenwich, CT 06831-5151 |
Second Address | Greenwich, CT 06831-5151 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2008 |
Last Update Date | 14/01/2020 |