Individual
KIRAN VITTAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
80 WALDO AVE, JERSEY CITY, NJ 07306-1455
(201) 320-7095
Mailing address
80 WALDO AVE, JERSEY CITY, NJ 07306-1455
(201) 320-7095
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ01362200
NJ
Other
Enumeration date
01/31/2023
Last updated
01/31/2023
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