Provider Demographics
NPI:1063691921
Name:ZAMMITO, KENNETH (DC)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:
Last Name:ZAMMITO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 W LACEY RD
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-2436
Mailing Address - Country:US
Mailing Address - Phone:609-693-2020
Mailing Address - Fax:609-693-8330
Practice Address - Street 1:442 W LACEY RD
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-2436
Practice Address - Country:US
Practice Address - Phone:609-693-2020
Practice Address - Fax:609-693-8330
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00249900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
426653XWFMedicare PIN