Healthcare Provider Details

I. General information

NPI: 1497685051
Provider Name (Legal Business Name): NEIGHBORHOOD VITALITY CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 NEPTUNE RD STE P12
POUGHKEEPSIE NY
12601-5571
US

IV. Provider business mailing address

3 NEPTUNE RD STE P12
POUGHKEEPSIE NY
12601-5571
US

V. Phone/Fax

Practice location:
  • Phone: 845-276-3906
  • Fax: --
Mailing address:
  • Phone: 845-276-3906
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: KANDICE KERSHAW
Title or Position: EXECUTIVE DIRECTOR
Credential: BS, MA
Phone: 845-276-3906