Provider Demographics
NPI:1326361650
Name:GAZZO, STEVEN A (MAPT)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:A
Last Name:GAZZO
Suffix:
Gender:M
Credentials:MAPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BOUNDARY AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-1152
Mailing Address - Country:US
Mailing Address - Phone:516-586-4766
Mailing Address - Fax:516-586-4758
Practice Address - Street 1:200 BOUNDARY AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-1152
Practice Address - Country:US
Practice Address - Phone:516-586-4766
Practice Address - Fax:516-586-4758
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011295225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist