Provider Demographics
NPI:1164602066
Name:GATTO, JOHN P (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:P
Last Name:GATTO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 STATE ROUTE 17C
Mailing Address - Street 2:
Mailing Address - City:OWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13827-4823
Mailing Address - Country:US
Mailing Address - Phone:607-687-8779
Mailing Address - Fax:607-687-2135
Practice Address - Street 1:1135 STATE ROUTE 17C
Practice Address - Street 2:
Practice Address - City:OWEGO
Practice Address - State:NY
Practice Address - Zip Code:13827-4823
Practice Address - Country:US
Practice Address - Phone:607-687-8779
Practice Address - Fax:607-687-2135
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039157183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01317500Medicaid