Provider Demographics
NPI:1578095469
Name:COMITO, JOSEPH M
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:M
Last Name:COMITO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15421 POWELLS COVE BLVD
Mailing Address - Street 2:
Mailing Address - City:BEECHHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1329
Mailing Address - Country:US
Mailing Address - Phone:917-750-1394
Mailing Address - Fax:
Practice Address - Street 1:15421 POWELLS COVE BLVD
Practice Address - Street 2:
Practice Address - City:BEECHHURST
Practice Address - State:NY
Practice Address - Zip Code:11357-1329
Practice Address - Country:US
Practice Address - Phone:917-750-1394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist