Healthcare Provider Details

I. General information

NPI: 1922074616
Provider Name (Legal Business Name): JOHN VITOLO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 LAFAYETTE RD STE D
SPARTA NJ
07871-3498
US

IV. Provider business mailing address

540 LAFAYETTE RD SUITE D
SPARTA NJ
07871-3447
US

V. Phone/Fax

Practice location:
  • Phone: 973-300-1553
  • Fax: 973-383-6236
Mailing address:
  • Phone: 973-300-1553
  • Fax: 973-383-6236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA46935
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MA04693500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: