Vitastat Medical PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

254736 Issued in NY

Legal business name

VITASTAT MEDICAL PLLC

Practice address

2322 Broadway
Astoria, NY 11106-4196

Phone

(917) 300-8296

Fax

(917) 300-8296

NPI assigned

Dec 4, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Ken Truong, M.D.NPI 1124282694

Title

Manager

Phone

(917) 300-8296

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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

• Ken Truong, MD

  • Internal Medicine Physician
  • Astoria, NY
  • NPI 1124282694
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1354579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354579200000",
    "number": "1811232770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8738 20TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144802",
            "telephone_number": "917-300-8296",
            "fax_number": "917-300-8296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2322 BROADWAY",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111064196",
            "telephone_number": "917-300-8296",
            "fax_number": "917-300-8296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITASTAT MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-04",
        "last_updated": "2012-12-04",
        "status": "A",
        "authorized_official_last_name": "TRUONG",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "917-300-8296",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "254736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn David Visconti Jr., PA-C
• Vision of Yonkers, Inc. (Urban Eyes)
• Hiral Visnagra
• Vitahealth Pharmacy, Inc.
• Vitalcare Supplies Corp
• Kevin Kareem Vitorino, RPH
• Lucia Daiana Voiculescu, M.D.
• Nonda L Volpe
• Tina Vournas, PHARMD
• VRT Consulting LLC

• Medical Specialty Clinic/Center in Astoria, NY
• Providers in Astoria, NY by specialty
• Medical Specialty Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.