| Vibrant Life Medicine, P.c. | |
|
286 Engle St Englewood NJ 07631-2405 | |
| (201) 569-6190 | |
| (201) 569-6940 |
| Full Name | Vibrant Life Medicine, P.c. |
|---|---|
| Speciality | General Practice |
| Location | 286 Engle St, Englewood, New Jersey |
| Authorized Official Name and Position | Erica Yoon-jung Song (PRESIDENT) |
| Authorized Official Contact | 2015696190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vibrant Life Medicine, P.c. 286 Engle St Englewood NJ 07631-2405 Ph: (201) 569-6190 | Vibrant Life Medicine, P.c. 286 Engle St Englewood NJ 07631-2405 Ph: (201) 569-6190 |
| NPI Number | 1053729319 |
|---|---|
| Provider Enumeration Date | 07/30/2014 |
| Last Update Date | 07/30/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053729319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 25MA07248000 (New Jersey) | Primary |
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