Provider Demographics
NPI:1679788004
Name:BRANCATO, VITO JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:VITO
Middle Name:JOSEPH
Last Name:BRANCATO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4506
Mailing Address - Country:US
Mailing Address - Phone:516-775-3915
Mailing Address - Fax:516-775-3958
Practice Address - Street 1:26 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-4506
Practice Address - Country:US
Practice Address - Phone:516-775-3915
Practice Address - Fax:516-775-3958
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0310021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice