Organization Active NPI

Vitality Medical Health PC

  • Pain Medicine (Anesthesiology) Physician
  • Old Westbury, NY
National Provider Identifier
1609713403
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
VITALITY MEDICAL HEALTH PC
Practice address
4 Pinewood Rd
Old Westbury, NY 11568-1606
Phone
(917) 862-5558
NPI assigned
Apr 30, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Authorized official

Name
Vitaly Kotlyar, MDNPI 1841427747
Title
MD
Phone
(917) 862-5558

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

4 Pinewood Rd
Old Westbury, NY 11568-1606

Mailing address

4 Pinewood Rd
Old Westbury, NY 11568-1606
Phone (917) 862-5558

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1777507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777507200000",
    "number": "1609713403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PINEWOOD RD",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115681606",
            "telephone_number": "917-862-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PINEWOOD RD",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115681606",
            "telephone_number": "917-862-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY MEDICAL HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-30",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A",
        "authorized_official_last_name": "KOTLYAR",
        "authorized_official_first_name": "VITALY",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "917-862-5558",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Westbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; 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.