Provider Demographics
NPI:1306986856
Name:MONITTO, DEAN K (DACM, LAC)
Entity type:Individual
Prefix:MR
First Name:DEAN
Middle Name:K
Last Name:MONITTO
Suffix:
Gender:M
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6165 JERICHO TURNPIKE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725
Mailing Address - Country:US
Mailing Address - Phone:631-352-2051
Mailing Address - Fax:631-982-4729
Practice Address - Street 1:6165 JERICHO TURNPIKE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725
Practice Address - Country:US
Practice Address - Phone:631-352-2051
Practice Address - Fax:631-982-4729
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1836171100000X
NY004643-01171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist