Active NPI
Vincent Cretella, RN
- Psychiatric/Mental Health Clinical Nurse Specialist
- Monticello, NY
National Provider Identifier
1831813013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Clinical Nurse Specialist
- License
- 303215-01
- Practice address
- 20 Crystal Street
Monticello, NY 12701 - Phone
- (845) 707-4326
- Fax
- (845) 707-4398
- NPI assigned
- Sep 30, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0808X | 303215-01 | NY | Primary |
Addresses
Primary practice location
20 Crystal Street
Monticello, NY 12701
Mailing address
20 Crystal Street
Monticello, NY 12701
Phone (845) 707-4326
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03308192 | Medicaid | NY |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 303215-01 | NY | MD | Psychiatric/Mental Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694736000000",
"number": "1831813013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 CRYSTAL STREET",
"city": "MONTICELLO",
"state": "NY",
"postal_code": "12701",
"telephone_number": "845-707-4326",
"fax_number": "845-707-4398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 CRYSTAL STREET",
"city": "MONTICELLO",
"state": "NY",
"postal_code": "12701",
"telephone_number": "845-707-4326",
"fax_number": "845-707-4398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRETELLA",
"first_name": "VINCENT",
"name_prefix": "Mr.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-30",
"last_updated": "2023-09-15",
"certification_date": "2023-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "364SP0808X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
"state": "NY",
"license": "303215-01",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03308192",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monticello, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.