Individual
MRS. DEBRA ROMA-DISTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
5301 BROADWAY, WEST NEW YORK, NJ 07093-2622
(201) 866-9320
Mailing address
23 PARKER CT, SOUTH AMBOY, NJ 08879-2200
(732) 727-5228
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
26NN07052100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0028401
—
NJ
Enumeration date
02/15/2006
Last updated
07/13/2007
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