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General NPI Number Information
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NPI Number | 1568087138
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Entity Type | Organization
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Legal Business Name | VITAL HEALTH MEDICAL CARE, PLLC
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Dates
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Enumeration Date | 06/10/2020
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 23 HADLEY CT
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City | PITTSFORD
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State | NY
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Zip | 14534-2838
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Country | US
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Telephone | 917-365-5214
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Fax |
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Provider Business Mailing Address
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Address Line | 23 HADLEY CT
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City | PITTSFORD
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State | NY
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Zip | 14534-2838
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Country | US
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Telephone | 917-365-5214
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | AKM ASHFAQUR RAHMAN
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Credential | MD, DO
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Telephone | 917-365-5214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RB0002X
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Taxonomy Name | Obesity Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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