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Individual

DR. CHARLES DESTEFANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
77 GOVERNOR RD, STATEN ISLAND, NY 10314-3021
(718) 273-9179
(718) 273-9179
Mailing address
77 GOVERNOR RD, STATEN ISLAND, NY 10314-3021
(718) 273-9179
(718) 273-9179

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
010175-1
NY

Other

Enumeration date
04/08/2010
Last updated
04/08/2010
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