Individual
MS. ANTOINETTE DISTEFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
26 DUMONT AVE, STATEN ISLAND, NY 10305-1450
(718) 667-8510
(718) 667-4524
Mailing address
26 DUMONT AVE, STATEN ISLAND, NY 10305-1450
(718) 667-8510
(718) 667-4524
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
679996-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000
—
NY
Enumeration date
04/10/2014
Last updated
04/10/2014
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