Vital PA PLLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

VITAL PA PLLC

Practice address

35-20 Leverich Street
Ste 230B
Jackson Heights, NY 11372-3973

Phone

(917) 517-5733

Fax

(718) 343-1157

NPI assigned

Aug 22, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Justo Martin Concepcion, MBA

Title

President

Phone

(917) 517-5733

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239321600000",
    "number": "1386750297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35-20 LEVERICH STREET",
            "address_2": "STE 230B",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113723973",
            "telephone_number": "917-517-5733",
            "fax_number": "718-343-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35-20 LEVERICH STREET",
            "address_2": "STE 230B",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113723973",
            "telephone_number": "917-517-5733",
            "fax_number": "718-343-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL PA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2009-04-10",
        "status": "A",
        "authorized_official_last_name": "CONCEPCION",
        "authorized_official_first_name": "JUSTO",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-517-5733",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Villalobos, DPT
• Susana Villalobos, LCSW
• Emilio B Villegas, MD
• Vision Quest Optical of Jackson Heights, Inc. (Lens Lab Express)
• Vital Health Medical Associates PLLC
• Kency Gisell Vitale, LMHC
• Viva Dental, P.C.
• Viva Pharmacy & Wellness
• Viva RX Inc
• Virginia Vizconde

• Surgical Physician Assistant in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2009; 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.