Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KENNETH LOUIS DISTEFANO, MD
Active Sole ProprietorDR. KENNETH LOUIS DISTEFANO, MD is a Family Medicine healthcare provider located in VERONA, New Jersey. NPI 1619146677 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · VERONA, NJ
Registration Details
- NPI Number
- 1619146677
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 25, 2008 (18.458763930411 yrs)
- Last Updated
- Jan 5, 2011
- Licenses
-
25MA08855100 (NJ)255630-1 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1 MOUNT PROSPECT AVEVERONA, NJ, 070442707Browse NJ providers · Browse ZIP 07044
- Phone
- 9732397777
- Fax
- 9732397082
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
Other Family Medicine Providers in VERONA, NJ
| Name | Credential | NPI |
|---|---|---|
| DR. GEORGE WALTER MILLER JR. | M.D. | 1316942618 |
| EVERETT SCHLAM | MD | 1033183629 |
| DR. SALLY A. MRAVCAK | M.D. | 1811009657 |
| DR. ELAINE VELLAS | M.D. | 1649362377 |
| DR. AMELIA STEINHARDT | M.D. | 1477645190 |
| THOMAS P MCCARRICK | M.D. | 1457411092 |
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.