Healthcare Provider Details

I. General information

NPI: 1043361603
Provider Name (Legal Business Name): STEVEN J. ZITO CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 03/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15001 SHADY GROVE RD
ROCKVILLE MD
20850-6352
US

IV. Provider business mailing address

13703 GREYFOX RUN
GLENELG MD
21737-9756
US

V. Phone/Fax

Practice location:
  • Phone: 301-340-7141
  • Fax:
Mailing address:
  • Phone: 301-653-5975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR115576
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: