Provider Demographics
NPI:1003205568
Name:ZITO, MAUREEN ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:ELIZABETH
Last Name:ZITO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:ELIZABETH
Other - Last Name:GALVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:47 NEW SCOTLAND AVE
Mailing Address - Street 2:MC 158
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3412
Mailing Address - Country:US
Mailing Address - Phone:518-262-5588
Mailing Address - Fax:
Practice Address - Street 1:1 CLARA BARTON DR
Practice Address - Street 2:MAIL CODE 181
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3401
Practice Address - Country:US
Practice Address - Phone:518-262-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002075133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric