Provider Demographics
NPI:1083986418
Name:JOSEPH R VITOLO MD PC
Entity Type:Organization
Organization Name:JOSEPH R VITOLO MD PC
Other - Org Name:NORTH SUFFOLK SURGICAL ASSOCIATES MD. PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:VITOLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-265-5544
Mailing Address - Street 1:48 ROUTE 25A
Mailing Address - Street 2:SUITE 308
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787
Mailing Address - Country:US
Mailing Address - Phone:631-265-5544
Mailing Address - Fax:631-862-3617
Practice Address - Street 1:48 ROUTE 25A
Practice Address - Street 2:SUITE 308
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787
Practice Address - Country:US
Practice Address - Phone:631-265-5544
Practice Address - Fax:631-862-3617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty