PATRICIA VASSALLO CPNP NPI 1194122937

NPI Information

NPI: 1194122937
Provider Name: PATRICIA VASSALLO, CPNP
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

PECOS Registration: Yes

Address:
22151 MOROSS RD
PB 2 SUITE 209
DETROIT, MI
ZIP 48236
Phone: (313) 343-3978
Get Directions

Patricia Vassallo, CPNP is a pediatrics nurse practitioner in Detroit, MI. Patricia Vassallo, CPNP NPI is 1194122937. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

22151 MOROSS RD
PB 2 SUITE 209
DETROIT, MI
ZIP 48236-167
Phone: (313) 343-3978
Fax: (313) 417-2730

The NPI 1194122937 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/21/2014 and was last updated on 6/22/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	4704268599	MICHIGAN	No
2	363LP0200X	Nurse Practitioner	Pediatrics	SP027691	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0H208910	OTHER	MICHIGAN	BLUE CROSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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