Healthcare Provider Details

I. General information

NPI: 1104193630
Provider Name (Legal Business Name): VINCENT MICHAEL ZITO RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2011
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 BOSTON POST RD
ORANGE CT
06477-3201
US

IV. Provider business mailing address

62 MAXWELL DR
MILFORD CT
06461-2738
US

V. Phone/Fax

Practice location:
  • Phone: 203-795-6001
  • Fax:
Mailing address:
  • Phone: 203-877-0724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4337
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: