Provider Demographics
NPI:1679696306
Name:VITAE MEDICAL PC
Entity Type:Organization
Organization Name:VITAE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARKADY
Authorized Official - Middle Name:
Authorized Official - Last Name:PINKHAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-896-2200
Mailing Address - Street 1:9830 67TH AVE STE FF
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4944
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9830 67TH AVE STE FF
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4944
Practice Address - Country:US
Practice Address - Phone:718-896-2200
Practice Address - Fax:718-830-6215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty