Destefano, Michael

Destefano, Michael is an individual health care provider with primary practice located at 75 N Country Rd , Port Jefferson NY 11777-2119. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Destefano, Michael can be contacted via phone (631) 473-1320.

Contact Information

Primary practice address
75 N Country Rd Port Jefferson NY 11777-2119
Phone: (631) 473-1320
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 301867 New York

Profile Details

NPI number 1407200116
LBN Legal business name Destefano, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2016
Last updated Feb 3rd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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