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Individual

JOHN DISTEFANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4755 OGLETOWN STANTON RD STE 5A43, NEWARK, DE 19718-2200
(302) 623-0188
(302) 733-5640
Mailing address
4755 OGLETOWN STANTON RD STE 5A43, NEWARK, DE 19718-2200
(302) 623-0188
(302) 733-5640

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C0009658
MD
363A00000X
Physician Assistant
Primary
C5-0012159
DE

Other

Enumeration date
07/20/2023
Last updated
10/18/2024
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