VIBRANT LIFE MEDICINE, P.C. (NPI# 1053729319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053729319 |
| Entity Type | Organization |
| Organization Name | VIBRANT LIFE MEDICINE, P.C. |
| Practice Address |
286 Engle St Englewood NJ 07631-2405 |
| Practice Telephone | 2015696190 |
| Practice Fax Number | 2015696940 |
| Mailing Telephone | 2015696190 |
| Mailing Fax Number | 2015696940 |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2014-07-30 |
| Authorized Official Name | DR. ERICA YOON-JUNG SONG (PRESIDENT) |
| Authorized Official Telephone | 2015696190 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 25MA07248000 | NJ | Allopathic & Osteopathic Physicians |
| Street Address |
286 ENGLE ST |
| City | ENGLEWOOD |
| State | NJ |
| Zip Code | 07631-2405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881645489 | Erica Yoon-jung Song | Obstetrics & Gynecology | 286 Engle St, Englewood, NJ 07631-2405 | 2006-05-16 |
| 1154626299 | Nofit Weiss Md,pc | Specialist | 286 Engle St, Englewood, NJ 07631-2405 | 2011-01-21 |
| 1205165594 | Nofit Weiss,md,pc | Obstetrics & Gynecology | 286 Engle St, Second Fl, Englewood, NJ 07631-2405 | 2009-12-15 |
| 1962453571 | Englewood Obgyn Womens Group, P.a. | Obstetrics & Gynecology | 286 Engle St, Englewood, NJ 07631-2405 | 2006-05-16 |
| 1366493058 | Yoon-bok Jhee | Obstetrics & Gynecology | 286 Engle St, Englewood, NJ 07631-2405 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447868922 | Sharmela Brijmohan | Student in an Organized Health Care Education/Training Program | 350 Engle Street Englewood Nj Department of Medicine, Englewood, NJ 07631 | 2020-07-21 |
| 1902422553 | Ross Tyrone Jensen Lavine | Student in an Organized Health Care Education/Training Program | 350 Engle Street, Department of Medicine, Englewood, NJ 07631 | 2020-06-19 |
| 1881235497 | Cbt and Psychodynamic Therapy Associates LLC | Social Worker | 245 Walnut Street, Englewood, NJ 07631 | 2019-10-04 |
| 1346895950 | Eb Care At Englewood, LLC | Assisted Living Facility | 412 South Van Brunt Street, Englewood, NJ 07631 | 2019-08-09 |
| 1730695727 | Maytal Elart | Spec/Tech, Cardiovascular | 151 E Palisades Ave, 16e, Englewood, NJ 07631 | 2017-12-28 |
| 1396259255 | Elizabeth Thottumalil Thomas | Counselor | 93 West Palisade Ave, Englewood, NJ 07631 | 2017-11-29 |
| 1992214381 | Englewood Orthopedics Group PC | Orthopaedic Surgery | 55 Smith St Unit 5653, Englewood, NJ 07631 | 2017-09-28 |
| 1639691579 | Jee Hoon Jang | Student in an Organized Health Care Education/Training Program | 350 Engle St., Englewood, NJ 07631 | 2017-07-12 |
| 1427570332 | Dan Ran Castillo | Student in an Organized Health Care Education/Training Program | 350 Engel Street, Engelwood, NJ 07631 | 2017-07-12 |
| 1275061392 | Thomas J Drexler | Counselor | 93 W. Palisades Ave, Englewood, NJ 07631 | 2017-06-02 |
| Find all providers in zip 07631 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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|---|---|---|---|---|
| 1770062085 | New Health Pain Treatment Centers, LLC | General Practice | 3605 S Teller, Englewood, CO 80205 | 2018-08-08 |
| 1275570517 | Lemon Bay Physicians, P.a. | General Practice | 1885 Englewood Rd, Englewood, FL 34223-1822 | 2006-06-02 |
| 1245731140 | New Health Pain Treatment Centers, LLC | General Practice | 3277 S Lincoln St, Englewood, CO 80113-2512 | 2018-02-26 |
| 1144742016 | Denver Springs Physician Group LLC | General Practice | 8835 American Way, Englewood, CO 80112-7056 | 2017-07-12 |
| 1255738050 | Puremed LLC | General Practice | 200 Engle St, Englewood, NJ 07631-2440 | 2014-11-24 |
| 1922354943 | Nj Spine and Neuropathy Center | General Practice | 200 Engle St, Suite 21, Englewood, NJ 07631-2440 | 2012-07-27 |
| 1528342458 | Restorx | General Practice | 420 Valley View Rd, Englewood, NJ 07631-1621 | 2011-10-11 |
| 1295938025 | Melissa Trapp | General Practice | 2955 S Broadway, Englewood, CO 80113-1526 | 2007-06-08 |
| 1831229673 | Rebekah S Hansmeier | General Practice | 2955 S Broadway, Englewood, CO 80113-1526 | 2007-03-07 |
| 1548398001 | Margaret A. Gainey M.d. | General Practice | 1861 Placida Rd, Suite 101, Englewood, FL 34223-4961 | 2007-02-28 |
| Find all providers in ENGLEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.