Individual
DR. MICHAEL DESTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 473-1320
Mailing address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 473-1320
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
301867
NY
Other
Enumeration date
04/19/2016
Last updated
02/03/2021
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