GREGORY S DESTEFANO APRN NPI 1720081110

NPI Information

NPI: 1720081110
Provider Name: GREGORY S DESTEFANO, APRN
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Organization: NORTH SHORE-LIJ MEDICAL GROUP PC

PECOS Registration: Yes

Address:
NP RESOURCES, LLC
SIX CORPORATE DRIVE, SUITE 420
SHELTON, CT
ZIP 06484
Phone: (203) 925-9600
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Gregory S Destefano, APRN is an adult health nurse practitioner in Shelton, CT with 25 years of experience. Gregory S Destefano, APRN NPI is 1720081110. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

NP RESOURCES, LLC
SIX CORPORATE DRIVE, SUITE 420
SHELTON, CT
ZIP 06484
Phone: (203) 925-9600

The NPI 1720081110 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/23/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	002291	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P16493	MEDICARE UPIN	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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