Provider Demographics
NPI:1275671372
Name:ZITO, LAUREN M (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:M
Last Name:ZITO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:M
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:4 SELMA CT
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-6107
Mailing Address - Country:US
Mailing Address - Phone:631-462-3500
Mailing Address - Fax:
Practice Address - Street 1:763 LARKFIELD RD STE 101
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3131
Practice Address - Country:US
Practice Address - Phone:631-462-0118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2010-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028754-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist