Vintage Vitality LLC

Primary specialty

Health EducatorTaxonomy code 174H00000X

Legal business name

VINTAGE VITALITY LLC

Practice address

516 Main St
East Orange, NJ 07018-2244

Phone

(973) 704-0196

NPI assigned

Mar 15, 2023

Organization subpart

No

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

Authorized official

Name

Althea Haynes, CHHPNPI 1639870868

Title

Practitioner

Phone

(973) 704-0196

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Althea Haynes

  • Health Educator
  • East Orange, NJ
  • NPI 1639870868
  NPD Authorized official

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1497456545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 MAIN ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182244",
            "telephone_number": "973-704-0196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 MAIN ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182244",
            "telephone_number": "973-704-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINTAGE VITALITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "ALTHEA",
        "authorized_official_title_or_position": "PRACTITIONER",
        "authorized_official_telephone_number": "973-704-0196",
        "authorized_official_credential": "CHHP"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bienvenido A Vidal, RPH
• Manoucheka B. Vilbrun, MSW, LCSW
• Village Super Market of NJ LP
• Ramil Villamor II, PT
• Joann Vincent
• Indu N Vira, MD
• Sheena Virdi, PA-C
• Virgo Medical Services, Inc
• Vision Care Medical Services, Inc
• Analita T Visitacion, RN

• Health Educator in East Orange, NJ
• Providers in East Orange, NJ by specialty
• Health Educator in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.