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VAULT MEDICAL SERVICES OF NEW JERSEY PC NPI 1073102778


NPI Information

NPI: 1073102778
Provider Name: VAULT MEDICAL SERVICES OF NEW JERSEY PC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 31D2246105

Address:
211 ESSEX ST STE 406
HACKENSACK, NJ
ZIP 07601
Phone: (929) 388-1551
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VAULT MEDICAL SERVICES OF NEW JERSEY PC is an internal medicine in Hackensack, NJ. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. VAULT MEDICAL SERVICES OF NEW JERSEY PC NPI is 1073102778. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

211 ESSEX ST STE 406
HACKENSACK, NJ
ZIP 07601-231
Phone: (929) 388-1551

The provider's authorized official is Alexander Wojciech Pastuszak .
The authorized official title is Chief Medical Officer/owner and has the following contact phone number (929) 388-1551.

The CLIA number assigned to this NPI record is 31D2246105 - mobile lab with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/16/2021 and was last updated on 1/16/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.