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General NPI Number Information
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NPI Number | 1013203439
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Entity Type | Organization
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Legal Business Name | VINCENT G. FIETTI, JR., M.D., P.C.
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Dates
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Enumeration Date | 06/23/2011
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Last Update Date | 06/23/2011
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Provider Practice Location Address
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Address Line | 1090 AMSTERDAM AVE SUITE 6E
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City | NEW YORK
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State | NY
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Zip | 10025-1737
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Country | US
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Telephone | 973-779-7361
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Fax | 973-779-7385
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Provider Business Mailing Address
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Address Line | 1060 CLIFTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07013-3638
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Country | US
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Telephone | 973-779-7361
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Fax | 973-779-7385
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Authorized Official
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Title or Position | CEO
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Name | DR. VINCENT G FIETTI JR.
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Credential | M.D.
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Telephone | 973-779-7361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 117102
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License Number State | NY
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