Basic Information
| Provider Information | |||||||||
| NPI: | 1477595114 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ZEOLI | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
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| Credential: | NPP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 VERMONT AVE | ||||||||
| Address2: | |||||||||
| City: | PORT JEFFERSON STATION | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117766116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314761410 | ||||||||
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| Practice Location | |||||||||
| Address1: | 445 OAK ST | ||||||||
| Address2: | FEGS COUNSELING CENTER | ||||||||
| City: | COPIAGUE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117263111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316917080 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 363LP0808X | F400793 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.