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General NPI Number Information
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NPI Number | 1053777201
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Entity Type | Organization
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Legal Business Name | VYTALIZ MEDICAL PC
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Dates
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Enumeration Date | 01/04/2016
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Last Update Date | 01/04/2016
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Provider Practice Location Address
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Address Line | 100 LEVERINGTON AVE SUITE 37
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City | PHILADELPHIA
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State | PA
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Zip | 19127-2039
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Country | US
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Telephone | 646-779-4311
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Fax |
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Provider Business Mailing Address
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Address Line | 298 5TH AVE 4TH FL
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City | NEW YORK
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State | NY
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Zip | 10001-4522
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Country | US
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Telephone | 646-779-4311
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMER ALNAJAR
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Credential | MD
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Telephone | 646-779-4311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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