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1790081107
THERESA VERTULLO
PATCHOGUE, NY
NPI
1790081107
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: NY F382155-1)
Enumeration Date
2011-02-02
Last Update Date
2012-03-26
Business Address
-- THERESA VERTULLO PNP
155 EAST WOODSIDE AVENUE
PATCHOGUE, NY 11772
Phone number: 631-758-6565
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Mailing Address
-- THERESA VERTULLO PNP
155 E WOODSIDE AVE
PATCHOGUE, NY 11772-1423
Phone number: 631-375-8486
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