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NPI Code Detail

MEDICARE: VITALITY HEALTHCARE SERVICES

MEDICARE: VITALITY HEALTHCARE SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1053243675
Entity Type Code : Organization
Provider Name (Legal Business Name) : VITALITY HEALTHCARE SERVICES
Provider Business Mailing Address
First Line : 324 NETHERLAND AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10303-2208
Country : US
Telephone Number : 347-219-0924
Fax Number :
Provider Business Practice Location Address
First Line : 750 MANHATTAN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11222-2910
Country : US
Telephone Number : 347-219-0924
Fax Number :
Authorized Official
Title or Position : CEO
Name : ANTHONIA O. LATUNJI
Credential : NP
Telephone Number : 347-219-0924
Provider Enumeration Date : 05/29/2026
Last Update Date : 05/29/2026

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Directions to “VITALITY HEALTHCARE SERVICES ” Practice Location

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