Individual
M JOSEPH VITOULIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
120 BROADWAY, LYNBROOK, NY 11563
(516) 593-0406
(516) 593-0406
Mailing address
120 BROADWAY, LYNBROOK, NY 11563
(516) 593-0406
(516) 593-0406
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
205528
NY
207Q00000X
Family Medicine Physician
Primary
205528
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01918905
—
NY
Enumeration date
10/18/2006
Last updated
09/07/2022
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