Provider Demographics
NPI:1447339270
Name:LAUTO, MICHAEL ANTHONY (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:LAUTO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 NORTH OCEAN AVENUE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-2012
Mailing Address - Country:US
Mailing Address - Phone:631-475-4515
Mailing Address - Fax:631-475-9846
Practice Address - Street 1:107 NORTH OCEAN AVENUE
Practice Address - Street 2:SUITE A
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-2012
Practice Address - Country:US
Practice Address - Phone:631-475-4515
Practice Address - Fax:631-475-9846
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1741251207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01080895Medicaid
NY22E071OtherBLUE CROSS
NYP369730OtherOXFORD
NY2417OtherVYTRA
A61321Medicare UPIN
NY22E071Medicare ID - Type Unspecified