Organization
VITALITY NP GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ETTIE TRESS (ADMINISTRATOR)
(732) 987-3855
Entity
Organization
Contact information
Practice address
45 LOGGERS MILL RD, HORSHAM, PA 19044-1924
(732) 282-7200
Mailing address
685 RIVER AVE UNIT 3, LAKEWOOD, NJ 08701-5288
(732) 486-7373
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Enumeration date
12/09/2019
Last updated
02/10/2025
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