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

TaxonomyCodeLicense
Adult Medicine Physician Primary 207QA0505X21567 (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.