Provider Demographics
NPI:1356597611
Name:PARTNERS IN FREEDOM
Entity type:Organization
Organization Name:PARTNERS IN FREEDOM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:VITALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-974-1980
Mailing Address - Street 1:2130 HIGHWAY 35 BLDG C
Mailing Address - Street 2:
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-1010
Mailing Address - Country:US
Mailing Address - Phone:732-974-1980
Mailing Address - Fax:
Practice Address - Street 1:2130 HIGHWAY 35 BLDG C
Practice Address - Street 2:
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-1010
Practice Address - Country:US
Practice Address - Phone:973-974-1980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARTNERS IN FREEDOM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty