Imelda L Vital, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

247815-1 Issued in NY

Practice address

3223 Church Ave
New York Avenue Medical
Brooklyn, NY 11226-4213

Phone

(718) 693-4900

Fax

(718) 287-8946

NPI assigned

Jul 22, 2014

Last updated

Jul 22, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New York Ave Pharmacy Inc

  • Community/Retail Pharmacy
  • Brooklyn, NY
  • NPI 1649393596
  NPD (past)

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1821405887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3223 CHURCH AVE",
            "address_2": "NEW YORK AVENUE MEDICAL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112264213",
            "telephone_number": "718-693-4900",
            "fax_number": "718-287-8946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 CHURCH AVE",
            "address_2": "NEW YORK AVENUE MEDICAL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112264213",
            "telephone_number": "718-693-4900",
            "fax_number": "718-287-8946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITAL",
        "first_name": "IMELDA",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "247815-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vital Network LLC
• Vital OT LLC
• Vital Path LLC
• Vital Rehab LLC
• Jacques Vital-Herne, M.D.
• Louis Gessai Vital, MD
• Vitale Counseling LCSW PC
• Christine M Vitale, MS
• Donna M. Vitale, D.C.
• Jessica Vitale, DDS

• Obstetrics & Gynecology Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.