Provider Demographics
NPI:1922174275
Name:URIARTE, VINCENT M (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:M
Last Name:URIARTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 SWORDFISH RD
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-1278
Mailing Address - Country:US
Mailing Address - Phone:609-660-1747
Mailing Address - Fax:856-794-5712
Practice Address - Street 1:142 SWORDFISH RD
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-1278
Practice Address - Country:US
Practice Address - Phone:609-660-1747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MAO2959200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE39891Medicare UPIN