Healthcare Provider Details

I. General information

NPI: 1851235212
Provider Name (Legal Business Name): VITAL WELLNESS NP IN FAMILY HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182 S MAIN ST STE 104
NEW CITY NY
10956-3318
US

IV. Provider business mailing address

182 S MAIN ST STE 104
NEW CITY NY
10956-3318
US

V. Phone/Fax

Practice location:
  • Phone: 845-358-4000
  • Fax: 845-358-4418
Mailing address:
  • Phone: 845-270-5081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. ANSA SAJI KANDAMKULATHY
Title or Position: NURSE PRACTITIONER
Credential: FNP,RN,CNN
Phone: 845-270-5081