Provider Demographics
NPI:1689488868
Name:ZOITAS, IOANNA
Entity type:Individual
Prefix:
First Name:IOANNA
Middle Name:
Last Name:ZOITAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 PLYMOUTH DR S
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-1131
Mailing Address - Country:US
Mailing Address - Phone:917-471-2477
Mailing Address - Fax:
Practice Address - Street 1:35 PLYMOUTH DR S
Practice Address - Street 2:
Practice Address - City:GLEN HEAD
Practice Address - State:NY
Practice Address - Zip Code:11545-1131
Practice Address - Country:US
Practice Address - Phone:917-471-2477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165889161172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver