Organization
VIDA MEDICAL, NEW JERSEY, P.C. NJ
Active
Organization
VIDA MEDICAL, NEW JERSEY, P.C. NJ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE ODONNELL (SR. MANAGER, COMPLIANCE)
(845) 721-6214
Entity
Organization
Contact information
Practice address
100 MONTGOMERY ST STE 750, SAN FRANCISCO, CA 94104-4302
(845) 721-6214
Mailing address
100 MONTGOMERY ST STE 750, SAN FRANCISCO, CA 94104-4302
(845) 721-6214
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
133V00000X
Registered Dietitian
—
—
171400000X
Health & Wellness Coach
—
—
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
12/01/2023
Last updated
07/21/2024
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