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General NPI Number Information
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NPI Number | 1386450674
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Entity Type | Organization
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Legal Business Name | VITAL HEALTH CENTERS
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 290 LAFAYETTE AVE STE 203
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City | HAWTHORNE
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State | NJ
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Zip | 07506-1928
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Country | US
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Telephone | 973-949-3777
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Fax |
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Provider Business Mailing Address
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Address Line | 10 BROMLEY CT
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City | VOORHEES
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State | NJ
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Zip | 08043-3922
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Country | US
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Telephone | 856-304-0152
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. VINCENT M PADULA
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Credential | DO
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Telephone | 856-304-0152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LA0401X
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Taxonomy Name | Addiction Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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