Provider Demographics
NPI:1518320274
Name:DRITTO, PAUL (RTT)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:DRITTO
Suffix:
Gender:M
Credentials:RTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 ORCHARD ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-5721
Mailing Address - Country:US
Mailing Address - Phone:516-606-5127
Mailing Address - Fax:
Practice Address - Street 1:34 ORCHARD ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-5721
Practice Address - Country:US
Practice Address - Phone:516-606-5127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3512112471R0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation Therapy