Individual
CARMINE SALVATORE DESTEFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
20 EBBITTS ST, STATEN ISLAND, NY 10306-4844
(718) 980-4400
Mailing address
20 EBBITTS ST, STATEN ISLAND, NY 10306-4844
(718) 980-4400
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
072726
NY
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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