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NPI Code Detail

MEDICARE: DR. JACQUES VITAL-HERNE M.D.

MEDICARE: DR. JACQUES VITAL-HERNE M.D.
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
12084P0800XPsychiatry Physician142858NY

General Provider Information

NPI Number : 1518291400
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACQUES VITAL-HERNE M.D.
Provider Business Mailing Address
First Line : 2857 LINDEN BLVD
Second Line :
City : BROOKLYN
State : NY
Zip : 11208-5126
Country : US
Telephone Number : 718-553-1100
Fax Number : 718-553-1111
Provider Business Practice Location Address
First Line : 2857 LINDEN BLVD
Second Line :
City : BROOKLYN
State : NY
Zip : 11208-5126
Country : US
Telephone Number : 718-553-1100
Fax Number : 718-553-1111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2009
Last Update Date : 09/24/2009

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Directions to “ DR. JACQUES VITAL-HERNE M.D.” Practice Location

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