# VITALITY MEDICAL HEALTH PC

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

## Provider details

- **NPI number:** 1609713403
- **Authorized official:** VITALY KOTLYAR MD (MD)
- **Authorized official phone:** (917) 862-5558

## Contact information

- **Practice address:** 4 PINEWOOD RD, OLD WESTBURY, NY 11568-1606
- **Practice address phone:** (917) 862-5558
- **Mailing address:** 4 PINEWOOD RD, OLD WESTBURY, NY 11568-1606
- **Mailing address phone:** (917) 862-5558

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/30/2026
- **Last updated:** 04/30/2026