MEDICARE: LYNDSEY VITO

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
1	103K00000X	Behavior Analyst	15BC00209300	NJ

General Provider Information

NPI Number	:	1811870082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNDSEY VITO

Provider Business Mailing Address
First Line	:	212 DUBOIS RD
Second Line	:
City	:	GLASSBORO
State	:	NJ
Zip	:	08028-1225
Country	:	US
Telephone Number	:	856-689-3066
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 SECOND AVE
Second Line	:
City	:	CAPE MAY
State	:	NJ
Zip	:	08204-1045
Country	:	US
Telephone Number	:	609-602-0165
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2025
Last Update Date	:	07/28/2025

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Directions to “ LYNDSEY VITO ” Practice Location

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