| NPI | 1063860872 |
|---|---|
| Former Name | CARLY MARIE VENDITTO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 6181) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F339574-1) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2020-07-08 |