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Individual

CARL VITALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 GALLOPING HILL RD, STE 107, UNION, NJ 07083-7989
(908) 964-7333
(908) 687-7855
Mailing address
1000 GALLOPING HILL RD, STE 107, UNION, NJ 07083-7989
(908) 964-7333
(908) 687-7855

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MA39610
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
205641CP5
MEDICARE ID-TYPE UNSPECIFIED
NJ
05
3343600
NJ
Enumeration date
04/27/2006
Last updated
10/05/2011
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