NPI 1053729319

Vibrant Life Medicine, P.C.

Organisation General Practice Physician Englewood, NJ

Practice location

Address: 286 Engle St, Englewood, NJ 07631-2405
Phone: (201) 569-6190
Fax: (201) 569-6940

Authorised official

Name: Erica Yoon-Jung Song
Title: President
Phone: (201) 569-6190

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 25MA07248000 (NJ)

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Registry record

NPI: 1053729319
Entity type: Organization
NPI issued: 30 Jul 2014
Record last updated: 30 Jul 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.