Provider Demographics
NPI:1356225536
Name:VITALITY ACUPUNCTURE LLC
Entity type:Organization
Organization Name:VITALITY ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SOFIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SYDORYAK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:215-687-3095
Mailing Address - Street 1:3305 DUBLIN MANOR RD
Mailing Address - Street 2:
Mailing Address - City:STREET
Mailing Address - State:MD
Mailing Address - Zip Code:21154-1925
Mailing Address - Country:US
Mailing Address - Phone:215-687-3095
Mailing Address - Fax:
Practice Address - Street 1:260 GATEWAY DR STE 9-10C
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4268
Practice Address - Country:US
Practice Address - Phone:215-687-3095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty