Provider Demographics
NPI:1407120389
Name:LA GATTUTA, BENITA (DC)
Entity Type:Individual
Prefix:DR
First Name:BENITA
Middle Name:
Last Name:LA GATTUTA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:BENITA
Other - Middle Name:
Other - Last Name:LA GATTUTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:37 FOOTHILL LN
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-4008
Mailing Address - Country:US
Mailing Address - Phone:631-266-3233
Mailing Address - Fax:
Practice Address - Street 1:37 FOOTHILL LN
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-4008
Practice Address - Country:US
Practice Address - Phone:631-266-3233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYXOO5731-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor