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General NPI Number Information
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NPI Number | 1770213621
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Entity Type | Organization
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Legal Business Name | VITALCHECK WELLNESS
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 241 W 37TH ST RM 402
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City | NEW YORK
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State | NY
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Zip | 10018-6818
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Country | US
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Telephone | 312-912-2408
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Fax |
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Provider Business Mailing Address
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Address Line | 241 W 37TH ST RM 402
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City | NEW YORK
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State | NY
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Zip | 10018-6818
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Country | US
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Telephone | 312-912-2408
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. AMIR MANSOUR
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Credential |
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Telephone | 312-912-2408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083C0008X
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Taxonomy Name | Clinical Informatics Physician
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License Number |
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License Number State |
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