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General NPI Number Information
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NPI Number | 1538610159
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Entity Type | Organization
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Legal Business Name | SALVATORE F. VITALE INC
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Dates
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Enumeration Date | 10/19/2016
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Last Update Date | 10/19/2016
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Provider Practice Location Address
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Address Line | 2038 NEW BEDFORD RD
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City | SPRING LAKE
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State | NJ
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Zip | 07762-2507
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Country | US
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Telephone | 732-245-9223
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Fax |
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Provider Business Mailing Address
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Address Line | 1541 HWY 88 W. STE. I
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City | BRICK
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State | NJ
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Zip | 08724-3422
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Country | US
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Telephone | 732-458-3422
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SALVATORE F VITALE
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Credential | M.D.
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Telephone | 732-245-9223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA02202800
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License Number State | NJ
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