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General NPI Number Information
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NPI Number | 1902542913
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Entity Type | Organization
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Legal Business Name | VITALS HEALTHCARE SVCS
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 375 LINDEN BLVD
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City | BROOKLYN
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State | NY
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Zip | 11203-2709
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Country | US
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Telephone | 917-907-0797
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Fax | 917-933-4212
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Provider Business Mailing Address
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Address Line | 375 LINDEN BLVD
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City | BROOKLYN
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State | NY
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Zip | 11203-2709
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Country | US
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Telephone | 917-907-0797
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Fax | 718-540-8678
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Authorized Official
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Title or Position | NP/OWNER
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Name | MS. PHEDRE PHARA PAULEMON
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Credential | NP
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Telephone | 917-907-0797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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