Provider Demographics
NPI:1609829985
Name:VITALI, JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:VITALI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CANDLEWOOD CMNS
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2172
Mailing Address - Country:US
Mailing Address - Phone:848-285-4671
Mailing Address - Fax:848-285-4673
Practice Address - Street 1:500 CANDLEWOOD CMNS
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2172
Practice Address - Country:US
Practice Address - Phone:848-285-4671
Practice Address - Fax:848-285-4673
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA058140207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1055691OtherHORIZON NJ HEALTH SEA GIR
NJ2591715OtherGHI
NJ13311OtherAETNA HMO HOWELL LOCATION
NJMP107OtherOXFORD
NJ1029602OtherUNITED HEALTHCARE
NJ1040679OtherHORIZON NJ HEALTH HOWELL
NJ4249471OtherAETNA PPO HOWELL LOCATION
NJ431884OtherPHCS
NJP00126198OtherRAILROAD MEDICARE
NJ0531223OtherCIGNA
NJ4249471OtherAETNA PPO SEA GIRT LOCATI
NJ5067041OtherCCN
NJ0295568000OtherAMERIHEALTH NJ
NJ140037OtherAETNA HMO SEA GIRT LOCATI
NJ763621OtherFIRST HEALTH
NJ5453402Medicaid
NJ2K5495OtherHEALTHNET OF THE NORTHEAS
NJ2K5495OtherHEALTHNET OF THE NORTHEAS
NJF34937Medicare UPIN