Healthcare Provider Details

I. General information

NPI: 1245153808
Provider Name (Legal Business Name): VITALITY HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 NETHERLAND AVE
STATEN ISLAND NY
10303-2208
US

IV. Provider business mailing address

324 NETHERLAND AVE
STATEN ISLAND NY
10303-2208
US

V. Phone/Fax

Practice location:
  • Phone: 347-524-1083
  • Fax: 347-524-1083
Mailing address:
  • Phone: 347-524-1083
  • Fax: 347-524-1083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANTHONIA LATUNJI
Title or Position: DIRECTOR
Credential: LATUNJI
Phone: 347-524-1083