Organization · Type 2 NPI
Anthony Distefano, JR MD
Adult Medicine Physician · Worcester, MA
NPI number
1063646552
Active
Practice location
562 Lincoln St
Worcester, MA 01605-1916
Fax (508) 721-7821
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Medicine Physician Primary | 207QA0505X | 21567 (MA) |
Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.
2 other providers at this address
About NPI 1063646552
Anthony Distefano, JR MD's National Provider Identifier is 1063646552, issued on May 12, 2009. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Worcester, MA. The record was last updated on May 12, 2009.