Organization
ANTHONY DISTEFANO, JR MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY J DISTEFANO JR. M.D. (OWNER)
(508) 852-6028
Entity
Organization
Contact information
Practice address
562 LINCOLN ST, WORCESTER, MA 01605-1916
(508) 852-6028
(508) 721-7821
Mailing address
562 LINCOLN ST, WORCESTER, MA 01605-1916
(508) 852-6028
(508) 721-7821
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
21567
MA
Other
Enumeration date
05/12/2009
Last updated
05/12/2009
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