NPIMap

Organization Active NPI

Vitality Medical Associates

  • Internal Medicine Physician
  • Paterson, NJ
National Provider Identifier
1861091878
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
VITALITY MEDICAL ASSOCIATES
Practice address
561 East 28TH Street
Paterson, NJ 07504-1862
Phone
(862) 239-6667
Fax
(973) 947-1300
NPI assigned
Oct 21, 2020
Last updated
Oct 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Authorized official

Name
Dr. Albert Siu, M.D.NPI 1063668895
Title
President
Phone
(862) 239-6667

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Internal Medicine Physician 207R00000X Primary
Nephrology Physician 207RN0300X

Addresses

Primary practice location

561 East 28TH Street
Paterson, NJ 07504-1862

Mailing address

P.O. Box 193
Livingston, NJ 07039-9998
Phone (862) 239-6667

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1861091878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 193",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070399998",
            "telephone_number": "862-239-6667",
            "fax_number": "973-947-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 EAST 28TH STREET",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075041862",
            "telephone_number": "862-239-6667",
            "fax_number": "973-947-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "SIU",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "862-239-6667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.