Basic Information
| Provider Information | |||||||||
| NPI: | 1518105733 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GATTO | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 TRIANGLE DR | ||||||||
| Address2: | |||||||||
| City: | SETAUKET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117331431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6318977179 | ||||||||
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| Practice Location | |||||||||
| Address1: | 101 NICOLLS RD | ||||||||
| Address2: | |||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117941551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314443575 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2009 | ||||||||
| LastUpdateDate: | 09/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 012958-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.