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NPI Code Detail

MEDICARE: VAIL HEALTHCARE NETWORK

MEDICARE: VAIL HEALTHCARE NETWORK
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
1207RP1001XPulmonary Disease Physician186141NY

General Provider Information

NPI Number : 1396166500
Entity Type Code : Organization
Provider Name (Legal Business Name) : VAIL HEALTHCARE NETWORK
Provider Business Mailing Address
First Line : 96 LINWOOD PLZ # 410
Second Line :
City : FORT LEE
State : NJ
Zip : 07024-3701
Country : US
Telephone Number : 201-681-5066
Fax Number :
Provider Business Practice Location Address
First Line : 1070 SOUTHERN BLVD
Second Line :
City : BRONX
State : NY
Zip : 10459-3268
Country : US
Telephone Number : 347-903-3072
Fax Number :
Authorized Official
Title or Position : PRESIDENT/CEO
Name : SAMUEL DELEON
Credential : MD
Telephone Number : 347-566-0515
Provider Enumeration Date : 12/16/2013
Last Update Date : 12/16/2013

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Directions to “VAIL HEALTHCARE NETWORK ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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