Vitality Wellness & Rehab LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

VITALITY WELLNESS & REHAB LLC

Practice address

66 Austin Blvd
Commack, NY 11725-5733

Phone

(914) 376-6100

NPI assigned

Mar 14, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Melissa Nieli

Title

Credentialing Manager

Phone

(914) 376-6100

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552521600000",
    "number": "1083173595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 AUSTIN BLVD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117255733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 AUSTIN BLVD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117255733",
            "telephone_number": "914-376-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY WELLNESS & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-14",
        "last_updated": "2019-03-14",
        "status": "A",
        "authorized_official_last_name": "NIELI",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "914-376-6100"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Alan Venezia, D.C
• Danielle Vinci
• Jaclyn Michelle Viola, PHARM.D.
• Vivek Viswanath, DDS
• Nicholas Vitale, D.P.T.
• Kathleen Ann Voorhees
• Sharon Vosefski, RN
• Sylvera Cuerpo Voskamp, PT
• Brian Wade, L.C.S.W
• Keri Jean Wagner, N.P.

• Internal Medicine Physician in Commack, NY
• Providers in Commack, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.