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General NPI Number Information
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NPI Number | 1316083553
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Entity Type | Individual
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Provider Name | VINCENT VACCARO PH.D
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Gender | Male
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 163 ENGLE ST BLDG 1
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2535
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Country | US
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Telephone | 201-567-4551
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Fax | 291-945-1568
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Provider Business Mailing Address
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Address Line | 163 ENGLE ST BLDG 1
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2535
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Country | US
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Telephone | 201-567-4551
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Fax | 291-945-1568
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 007145-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | SI 00290200
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License Number State | NJ
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