Kyle A Vatalaro, LCSW

NPI #1962708032 in Medford, New York

Provider Information

NPI Number: 1962708032
Entity Type: Individual
Name: Kyle A Vatalaro, LCSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: LCSW
Enumeration Date: Feb 7, 2011
Last Updated: Dec 30, 2014

Practice Location

Address: 3251 ROUTE 112
Address 2: BUILDING #9
City: Medford
State: New York
ZIP Code: 11763-1446
Phone: (631) 451-6007

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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