Active NPI
Brianna Marie Vultaggio
- Technician/Technologist
- Shelby Township, MI
National Provider Identifier
1760066716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician/Technologist
- Practice address
- 49970 Van Dyke Ave
Shelby Township, MI 48317-1347 - Phone
- (586) 991-6596
- Fax
- (248) 712-4381
- NPI assigned
- May 6, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Technician/Technologist | 156F00000X | Primary |
Addresses
Primary practice location
49970 Van Dyke Ave
Shelby Township, MI 48317-1347
Mailing address
51145 Nicolette Dr
Chesterfield, MI 48047-4585
Phone (586) 228-9991
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624924800000",
"number": "1760066716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51145 NICOLETTE DR",
"city": "CHESTERFIELD",
"state": "MI",
"postal_code": "480474585",
"telephone_number": "586-228-9991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49970 VAN DYKE AVE",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483171347",
"telephone_number": "586-991-6596",
"fax_number": "248-712-4381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VULTAGGIO",
"first_name": "BRIANNA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-06",
"last_updated": "2021-06-29",
"certification_date": "2021-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "156F00000X",
"taxonomy_group": "",
"desc": "Technician/Technologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelby Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.