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General NPI Number Information
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NPI Number | 1861797789
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Entity Type | Organization
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Legal Business Name | CARL A. VITOLA, DO PC
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Dates
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Enumeration Date | 01/25/2011
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 900 ROUTE 168 SUITE C3
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-3233
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Country | US
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Telephone | 856-374-0430
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Fax | 856-374-0048
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Provider Business Mailing Address
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Address Line | 900 ROUTE 168 SUITE C3
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-3233
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Country | US
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Telephone | 856-374-0430
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Fax | 856-374-0048
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. CARL A VITOLA
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Credential | DO
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Telephone | 856-374-0430
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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 | MB36306
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License Number State | NJ
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