Kim A Vitacco (NPI# 1912908484, PAC ID# 1951350602) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1912908484 |
| PAC ID by PECOS | 1951350602 |
| Professional Enrollment ID | I20061110000382 |
| Full Name | Kim A Vitacco |
| Address |
2 Shelter Harbor Ct Wading River NY 11792-2202 |
| Phone Number | 6312550890 |
| Gender | F |
| Credential | NP |
| Medical School | STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE |
| Graduation Year | 2003 |
| Primary Specialty | NURSE PRACTITIONER |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330185 | JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON |
| Address | Phone | Organization |
|---|---|---|
| 2 Shelter Harbor Ct, Wading River, NY 11792-2202 | 6312550890 |
| Street Address |
2 SHELTER HARBOR CT |
| City | WADING RIVER |
| State | NY |
| Zip | 11792-2202 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Donale H Kazenoff | Clinical Social Worker | 232 Sound Rd, Wading River, NY 11792-1045 | |
| Jeanne F Vecchio | Clinical Social Worker | 115 Cliff E Rd, Wading River, NY 11792-1245 | |
| Anne V Nienstedt | Family Medicine | 67 Karen Ct, Wading River, NY 11792-1962 | |
| Robert Bernard | Internal Medicine | 5972 Route 25a, Wading River, NY 11792-2001 | |
| Teresa A Habacker | Hand Surgery | 5954 Route 25a, Wading River, NY 11792-2001 | |
| Marion R Golden | Nurse Practitioner | 5976 Route 25 A, Wading River, NY 11792-2001 | |
| Walter P Vancura | Physical Therapy | Wading River Physical Therapy, PC | 5958 Route 25a, Wading River, NY 11792-2001 |
| Michael J Tadros | Internal Medicine | Island Comprehensive Care Inc | 6144 Route 25a, Suite 13, Wading River, NY 11792-2008 |
| Neil D Jaglall | Internal Medicine | Island Comprehensive Care Inc | 6144 Route 25a, Suite 13, Wading River, NY 11792-2008 |
| Cynthia S Ochi | Chiropractic | 6144 Route 25a, Suite 18, Wading River, NY 11792-2008 | |
| Find all physicians in zip 11792 | |||
| City | WADING RIVER |
| Zip Code | 11792 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | WADING RIVER + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Kim A Vitacco.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.