Healthcare Provider Details

I. General information

NPI: 1164294989
Provider Name (Legal Business Name): NINA ZITO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2023
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2023 E 67TH ST
BROOKLYN NY
11234-6007
US

IV. Provider business mailing address

2023 E 67TH ST
BROOKLYN NY
11234-6007
US

V. Phone/Fax

Practice location:
  • Phone: 917-373-0794
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: