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Individual

LAUREN A VITOLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS,PA-C

Contact information

Practice address
128 COLUMBIA TPKE, SUITE 200, FLORHAM PARK, NJ 07932-2283
(973) 736-9535
(973) 736-2607
Mailing address
128 COLUMBIA TPKE, SUITE 200, FLORHAM PARK, NJ 07932-2283
(973) 736-9535
(973) 736-2607

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00125000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
223777703
COMMERCIAL INSURANCES
NJ
Enumeration date
04/18/2006
Last updated
12/05/2012
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