Provider Demographics
NPI:1730203670
Name:ZITO, MICHAEL DOMINICK (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DOMINICK
Last Name:ZITO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:776 MOUNTAIN BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069-6269
Mailing Address - Country:US
Mailing Address - Phone:908-753-8696
Mailing Address - Fax:908-757-2911
Practice Address - Street 1:51 SOUTH ST STE 1
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-8107
Practice Address - Country:US
Practice Address - Phone:973-539-5600
Practice Address - Fax:908-757-2911
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00359900103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent