Individual
IMELDA L VITAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3223 CHURCH AVE, NEW YORK AVENUE MEDICAL, BROOKLYN, NY 11226-4213
(718) 693-4900
(718) 287-8946
Mailing address
3223 CHURCH AVE, NEW YORK AVENUE MEDICAL, BROOKLYN, NY 11226-4213
(718) 693-4900
(718) 287-8946
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
247815-1
NY
Other
Enumeration date
07/22/2014
Last updated
07/22/2014
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