Vytalize Health Oh Aco LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

VYTALIZE HEALTH OH ACO LLC

Practice address

2 Hudson PL
Hoboken, NJ 07030-5594

Phone

(201) 205-2628

NPI assigned

May 16, 2022

Organization subpart

No

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

Authorized official

Name

Faris Ghawi

Title

Owner

Phone

(201) 205-2628

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1669119368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 HUDSON PL",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305594",
            "telephone_number": "201-205-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 HUDSON PL",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305594",
            "telephone_number": "201-205-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VYTALIZE HEALTH OH ACO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "GHAWI",
        "authorized_official_first_name": "FARIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-205-2628"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine F Vo, PHARMD
• Amanda Vojta
• Tina Vridhachalam
• Richard Vu, NP
• Vytalize Health Medical 2 LLC
• Vytalize Medical PA
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Hannah Walker, BCBA

• Internal Medicine Physician in Hoboken, NJ
• Providers in Hoboken, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.