Optimum Vitality

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA06252500 Issued in NJ

Legal business name

OPTIMUM VITALITY

Practice address

535 High Mountain Rd
Suite 110
North Haledon, NJ 07508-2665

Phone

(973) 427-2711

Fax

(973) 427-2770

NPI assigned

Jan 10, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shelly Parra

Title

Assistant Manager

Phone

(973) 427-2711

Specialties & licenses 1

Addresses

Tax ID family

Dr Goodnight Center for Everlasting Beauty2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dr Goodnight Center for Everlasting Beauty

  • Facial Plastic Surgery Physician
  • North Haledon, NJ
  • NPI 1437470895
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James W Goodnight, M.D.

  • Specialist
  • North Haledon, NJ
  • NPI 1144313131
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437208121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 HIGH MOUNTAIN ROAD",
            "address_2": "SUITE 110",
            "city": "NORTH HALEDON",
            "state": "NJ",
            "postal_code": "07508",
            "telephone_number": "973-427-2711",
            "fax_number": "973-427-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 HIGH MOUNTAIN RD",
            "address_2": "SUITE 110",
            "city": "NORTH HALEDON",
            "state": "NJ",
            "postal_code": "075082665",
            "telephone_number": "973-427-2711",
            "fax_number": "973-427-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM VITALITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARRA",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "ASSISTANT  MANAGER",
        "authorized_official_telephone_number": "973-427-2711",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA06252500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mua Solutions,Inc
• Kathlene Margaret Nagy
• North Haledon Dental LLC
• North Haledon Medical
• Carmen John Occhiuzzi, D.C.
• Chelsea Otte, LAT, ATC
• Evelyn Paz
• Peter Perera, D.M.D., PA.
• Barbara A. Porcelli, LCSW
• Jennifer Puskas, LCSW

• Specialist in North Haledon, NJ
• Providers in North Haledon, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.