Provider Demographics
NPI:1982077996
Name:VYTALIZ MEDICAL
Entity type:Organization
Organization Name:VYTALIZ MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMER
Authorized Official - Middle Name:
Authorized Official - Last Name:ALNAJAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-779-4311
Mailing Address - Street 1:30 ERIC CT
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1060
Mailing Address - Country:US
Mailing Address - Phone:646-779-4311
Mailing Address - Fax:
Practice Address - Street 1:30 ERIC CT
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1060
Practice Address - Country:US
Practice Address - Phone:646-779-4311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty