Provider Demographics
NPI:1437277803
Name:DAIUTO, CHRISTOPHER A (LMSW)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:A
Last Name:DAIUTO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 WAVERLY AVE
Mailing Address - Street 2:BLDG 3
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-1555
Mailing Address - Country:US
Mailing Address - Phone:631-363-2001
Mailing Address - Fax:631-363-2017
Practice Address - Street 1:450 WAVERLY AVE
Practice Address - Street 2:BLDG 3
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-1555
Practice Address - Country:US
Practice Address - Phone:631-363-2001
Practice Address - Fax:631-363-2017
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0696771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical