Organization
VINCENT DESTASIO DO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANDREA BACK (OFFICE MANAGER)
(732) 255-6566
Entity
Organization
Contact information
Practice address
1851 HOOPER AVE, SUITE A, TOMS RIVER, NJ 08753-8150
(732) 255-6566
(732) 255-3085
Mailing address
1851 HOOPER AVE, ST A, TOMS RIVER, NJ 08753-8150
(732) 255-6566
(732) 255-3085
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/10/2006
Last updated
07/29/2008
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