Provider Demographics
NPI:1316934573
Name:ZITKUS, BRUCE S (EDD, ANP-BC, FNP-BC)
Entity type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:S
Last Name:ZITKUS
Suffix:
Gender:M
Credentials:EDD, ANP-BC, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:87 CALVIN AVE
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-2136
Mailing Address - Country:US
Mailing Address - Phone:631-330-9693
Mailing Address - Fax:949-209-5623
Practice Address - Street 1:VISITING NURSE SERVICE & HOSPICE OF SUFFOLK, INC.
Practice Address - Street 2:505 MAIN STREET
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768
Practice Address - Country:US
Practice Address - Phone:631-439-2740
Practice Address - Fax:631-912-1417
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY421621363LF0000X
NY301909363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP06431Medicare UPIN