Healthcare Provider Details

I. General information

NPI: 1336299346
Provider Name (Legal Business Name): CELESTE DOLORES ZAFFUTO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 157TH ST
WHITESTONE NY
11357-3237
US

IV. Provider business mailing address

1620 157TH ST
WHITESTONE NY
11357-3237
US

V. Phone/Fax

Practice location:
  • Phone: 646-327-9864
  • Fax: 718-746-3036
Mailing address:
  • Phone: 646-327-9864
  • Fax: 718-746-3036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number204097
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: