Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner | ||
N | 225X00000X | Occupational Therapist | ||
N | 226300000X | Kinesiotherapist |
NPI | 1073044459 |
---|---|
Provider Name | Christopher Dito |
First Address | Lindenhurst, NY 11757-5425 |
Second Address | Lindenhurst, NY 11757-5425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2017 |
Last Update Date | 27/03/2017 |