Organization
VITALCARE MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMICA SHEILA LAWSON APN (CEO)
(973) 985-8382
Entity
Organization
Contact information
Practice address
34 UNION AVE, SUITE 1, IRVINGTON, NJ 07111-3219
(973) 985-8382
Mailing address
PO BOX 8210, GLEN RIDGE, NJ 07028-8210
(973) 985-8382
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00486800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0417106
—
NJ
Enumeration date
03/08/2017
Last updated
03/08/2017
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