Basic Information
| Provider Information | |||||||||
| NPI: | 1376591529 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZOTTO | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 213 MONTAUK HWY | ||||||||
| Address2: | |||||||||
| City: | WEST SAYVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117961800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6315636205 | ||||||||
| FaxNumber: | 6315637718 | ||||||||
| Practice Location | |||||||||
| Address1: | 41 JOHN ST | ||||||||
| Address2: | |||||||||
| City: | BABYLON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117022932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6318934355 | ||||||||
| FaxNumber: | 6315637718 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 12/01/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 204239 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 52V301 | 01 | NY | MEDICARE ID | OTHER |