Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JACK V DITEODORO, M.D.
Active Sole ProprietorDR. JACK V DITEODORO, M.D. is a Family Medicine healthcare provider located in STAMFORD, Connecticut. NPI 1346338837 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · STAMFORD, CT
Registration Details
- NPI Number
- 1346338837
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 10, 2006 (19.83456087729 yrs)
- Last Updated
- Oct 3, 2010
- Licenses
-
035558 (CT)035558 (CT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
90 MORGAN STSUTIE # 303STAMFORD, CT, 069055466Browse CT providers · Browse ZIP 06905
- Phone
- 2033236873
- Fax
- 2033589775
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
Other Family Medicine Providers in STAMFORD, CT
| Name | Credential | NPI |
|---|---|---|
| HENRY YOON | M.D. | 1790786259 |
| TABITHA FORTT | MD | 1427050426 |
| ROBERT MARK CHASUK | MD | 1942202627 |
| DR. DAVID M LAUREN | D.O. | 1629069653 |
| CLARISSA M PHELPS | M.D. | 1366416885 |
| DEBRA SUSAN GRAMLICH | M.D. | 1033176094 |
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.