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Individual

RICHARD M VITALI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
111 CENTRAL AVE FL 3, NEWARK, NJ 07102-1909
(973) 877-2825
(973) 877-5317
Mailing address
11 21ST ST, JERICHO, NY 11753-2507
(973) 877-2825
(973) 877-5317

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
25MP00103000
NJ

Other

Enumeration date
05/04/2007
Last updated
07/08/2007
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