Vitalized Performance Group

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

VITALIZED PERFORMANCE GROUP

Practice address

212 New London Tpke Ste D
Glastonbury, CT 06033-4202

Phone

(860) 430-2342

Fax

(860) 430-2342

NPI assigned

Aug 10, 2022

Organization subpart

No

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

Authorized official

Name

Gorica Mladen-Adduci

Title

Owner

Phone

(917) 560-0249

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Lee Dubicki, LAC

  • Acupuncturist
  • Glastonbury, CT
  • NPI 1427201540
  NPD (past)

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1467180299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 NEW LONDON TPKE STE D",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334202",
            "telephone_number": "860-430-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 NEW LONDON TPKE STE D",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334202",
            "telephone_number": "860-430-2342",
            "fax_number": "860-430-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALIZED PERFORMANCE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "MLADEN-ADDUCI",
        "authorized_official_first_name": "GORICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-560-0249"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427201540",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609232081",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992858583",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vpgwaves@vpgwaves.com",
            "affiliation": "N",
            "address_1": "212 New London Tpke Ste D",
            "city": "Glastonbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060334202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paul M Vella, M.D.
• Sharada Vemula, PHARMACIST
• Vicki Garvin, PH.D., LLC
• John Vischio, M.D.
• Vista Counseling Associates, LLC
• Vivo Chiropractic Glastonbury LLC
• Hannah Vollinger, AU.D.
• Katherine E Voss, PA-C
• Michael D Waddington, DO
• Waylee Lane Wagoner

• Acupuncturist in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Acupuncturist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.