Provider Demographics
NPI:1164396370
Name:VENDITTELLI, CONCETTA
Entity type:Individual
Prefix:
First Name:CONCETTA
Middle Name:
Last Name:VENDITTELLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 E MAIN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:44057-3285
Mailing Address - Country:US
Mailing Address - Phone:440-983-9056
Mailing Address - Fax:
Practice Address - Street 1:18 E MAIN ST APT 2
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-3285
Practice Address - Country:US
Practice Address - Phone:440-983-9056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty