Healthcare Provider Details

I. General information

NPI: 1407350796
Provider Name (Legal Business Name): KRISTEN ZAFFUTO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 03/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270-05 76TH AVENUE ONCOLOGY BUILDING
NEW HYDE PARK NY
11040-1402
US

IV. Provider business mailing address

3 SUZANNE B CT
MASSAPEQUA NY
11758-7300
US

V. Phone/Fax

Practice location:
  • Phone: 718-470-7499
  • Fax:
Mailing address:
  • Phone: 516-384-5803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number645294
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number308367
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: