Individual
MICHAEL WILLIAM DESTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MICHAEL DESTEFANO
Contact information
Practice address
1300 YORK AVE, NEW YORK, NY 10065-4805
(646) 962-9649
Mailing address
1 FEDERAL ST STE SW200, CAMDEN, NJ 08103-1155
(856) 356-4924
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA10390300
NJ
2085R0202X
Diagnostic Radiology Physician
278012-1
NY
Other
Enumeration date
06/17/2010
Last updated
04/12/2023
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