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General NPI Number Information
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NPI Number | 1437349644
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Entity Type | Organization
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Legal Business Name | JOHN VITOLO, M.D. P.C.
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 12/31/2007
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Provider Practice Location Address
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Address Line | 540 LAFAYETTE RD SUITE D
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City | SPARTA
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State | NJ
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Zip | 07871-3447
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Country | US
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Telephone | 973-300-1553
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Fax |
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Provider Business Mailing Address
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Address Line | 540 LAFAYETTE RD SUITE D
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City | SPARTA
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State | NJ
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Zip | 07871-3447
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Country | US
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Telephone | 973-300-1553
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | JOHN VITOLO
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Credential | M.D.
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Telephone | 973-300-1553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA46935
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License Number State | NJ
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