Provider Demographics
NPI:1902328768
Name:VACCARINO, VANESSA CATE
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:CATE
Last Name:VACCARINO
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 1:30 QUAIL HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:GLENMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12077-4425
Mailing Address - Country:US
Mailing Address - Phone:518-860-8176
Mailing Address - Fax:
Practice Address - Street 1:476 APPLETON ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-4186
Practice Address - Country:US
Practice Address - Phone:518-860-8176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker