DR. KENNETH LOUIS DISTEFANO MD NPI 1619146677

NPI Information

NPI: 1619146677
Provider Name: DR. KENNETH LOUIS DISTEFANO, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
1 MOUNT PROSPECT AVE
VERONA, NJ
ZIP 07044
Phone: (973) 239-7777
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DR. Kenneth Louis Distefano, MD is a family medicine in Verona, NJ. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Kenneth Louis Distefano, MD NPI is 1619146677. 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:

1 MOUNT PROSPECT AVE
VERONA, NJ
ZIP 07044-707
Phone: (973) 239-7777
Fax: (973) 239-7082

The enumeration date for this NPI number is 2/25/2008 and was last updated on 1/5/2011.

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	207Q00000X	Family Medicine		255630-1	NEW YORK	No
2	207Q00000X	Family Medicine		25MA08855100	NEW JERSEY	Yes

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: 5/5/2024

NPI Synchronization or Removal

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