MEDICARE: MR. VITO ROCCO TARULLI JR. PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1386506129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VITO ROCCO TARULLI JR. PA-C

Provider Business Mailing Address
First Line	:	164 GRAND ST APT 3
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-6452
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 E 18TH ST STE 21
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-3605
Country	:	US
Telephone Number	:	212-598-6137
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “ MR. VITO ROCCO TARULLI JR. PA-C” Practice Location

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