Gordana D Vitaliano, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

227906 Issued in MA

Practice address

McLean Hospital, DBRP
115 Mill Street
Belmont, MA 02478

Phone

(617) 855-2957

NPI assigned

Aug 7, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053320192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 LONGFELLOW PL",
            "address_2": "APT. 2105",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142838",
            "telephone_number": "617-855-2957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MCLEAN HOSPITAL, DBRP",
            "address_2": "115 MILL STREET",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "02478",
            "telephone_number": "617-855-2957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALIANO",
        "first_name": "GORDANA",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "227906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Belmont, MA
• Providers in Belmont, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.