Organization
VITAL MEDICAL CARE AESTHETICS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOELLE VITAL M.D. (OWNER)
(516) 414-1101
Entity
Organization
Contact information
Practice address
2209 MERRICK RD STE 202, MERRICK, NY 11566-4770
(516) 414-1101
(516) 414-1131
Mailing address
17 W OAK ST, AMITYVILLE, NY 11701-2960
(631) 608-1192
(631) 608-2770
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
234089
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02687236
—
NY
Enumeration date
08/18/2010
Last updated
02/04/2025
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