Healthcare Provider Details

I. General information

NPI: 1477595114
Provider Name (Legal Business Name): CHRISTOPHER ZEOLI NPP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 OAK ST FEGS COUNSELING CENTER
COPIAGUE NY
11726-3111
US

IV. Provider business mailing address

2 VERMONT AVE
PORT JEFFERSON STATION NY
11776-6116
US

V. Phone/Fax

Practice location:
  • Phone: 631-691-7080
  • Fax:
Mailing address:
  • Phone: 631-476-1410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF400793
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: