Look up the most recent NPI and PECOS records

Mary Vitale

Speech-Language Pathologist

Speech, Language and Hearing Service Providers

52 Roman Ave, Staten Island, NY 10314-2721

PECOS Enrollment

Based on the most recent information from CMS, provider Mary Vitale does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1700130101
Provider Type
Individual
Full Name
Vitale, Mary
Credential
M.S. CCC SLP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
11/7/2012
Last Updated
5/2/2017

Contact Information

Practice Location

52 Roman Ave, Staten Island, NY 10314-2721

(917) 586-2964

Unlisted Fax

Mailing Location

52 Roman Ave, Staten Island, NY 10314-2721

(917) 586-2964

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 235Z00000X Primary	Description Speech-Language Pathologist Speech, Language and Hearing Service Providers	License 022956-1 New York

Provider Identifiers

ID	Description	Issuer
ID 03764472	Description Medicaid	Issuer Unlisted New York

Mary Vitale

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Marsala, Emily

Hanna, Maryann

Kierman, Elisheva

Labarbera, Judith

Elgawly, Christine

Walsh-Hoey, Kathleen

Lee, Adrienne D

Edgar, Nicole B

Copulos, Willow Vivian

Priolo, Alanna