Healthcare Provider Details

I. General information

NPI: 1841874500
Provider Name (Legal Business Name): VITALITY WELLNESS PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MADISON AVE FL 6
NEW YORK NY
10022-5403
US

IV. Provider business mailing address

1 UNIVERSITY PL APT 5P
NEW YORK NY
10003-4565
US

V. Phone/Fax

Practice location:
  • Phone: 908-285-8179
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JULIE ANN AUERON
Title or Position: FOUNDER
Credential: PT, DPT
Phone: 212-752-6770