Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KENNETH L DISTEFANO SR., MD
Active Sole ProprietorDR. KENNETH L DISTEFANO SR., MD is a Plastic Surgery healthcare provider located in VERONA, New Jersey. NPI 1346324852 is currently active in the NPPES registry. Verify at CMS.
Plastic Surgery · VERONA, NJ
Registration Details
- NPI Number
- 1346324852
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 24, 2006 (19.777368961755 yrs)
- Last Updated
- Sep 6, 2023
- License
-
25MA02454300 (NJ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1 MOUNT PROSPECT AVEVERONA, NJ, 070442707Browse NJ providers · Browse ZIP 07044
- Phone
- 9732397777
- Fax
- 9732397082
- Primary Specialty
-
Plastic Surgery
208200000X
Other Plastic Surgery Providers in VERONA, NJ
| Name | Credential | NPI |
|---|---|---|
| ROBERT AGRESTI | D.O. | 1619155710 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.