# VITALITY NP GROUP LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083356307
- **Authorized official:** ETTIE TRESS (OWNER)
- **Authorized official phone:** (732) 486-7373

## Contact information

- **Practice address:** 511 CHANTECLER AVE STE 1, RICHMOND, VA 23226-3000
- **Practice address phone:** (732) 486-7373
- **Practice address fax:** (732) 282-7200
- **Mailing address:** 685 RIVER AVE UNIT 3, LAKEWOOD, NJ 08701-5288
- **Mailing address phone:** (732) 486-7373

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | NULL | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/07/2022
- **Last updated:** 06/22/2023