Anthony Distefano, Jr MD
Family Medicine, Adult Medicine in Worcester, Massachusetts
1063646552- Practice location
- 562 Lincoln St, Worcester, MA 01605-1916
- Phone
- 508-852-6028
- Fax
- 508-721-7821
- Last updated
- May 12, 2009
Anthony Distefano, Jr MD is a healthcare organization based in Worcester, MA. Anthony Distefano, Jr MD practices in Worcester, MA. The NPI Number for Anthony Distefano, Jr MD is 1063646552 and holds a License No. 21567 (MA). The current practice location address for Anthony Distefano, Jr MD is 562 Lincoln St, Worcester, MA 01605-1916 and can be reached out via phone at 508-852-6028 and via fax at 508-721-7821.
Provider Profile Details
- NPI Number
- 1063646552
- Provider Name
- Anthony Distefano, Jr MD
- Provider Entity Type
- Organization
- Address
- 562 Lincoln St, Worcester, MA 01605-1916
- Phone Number
- 508-852-6028
- Fax Number
- 508-721-7821
- Primary Taxonomy
- Family Medicine, Adult Medicine · 207QA0505X
- Organization Subpart
- No
- Authorized Official
- Anthony J Distefano, MD · Owner · 508-852-6028
- Provider Enumeration Date
- May 12, 2009
- Last Update Date
- May 12, 2009
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 562 Lincoln St
Worcester, MA 01605-1916 - City
- Worcester
- State
- Massachusetts
- Zip
- 01605-1916
- Phone Number
- 508-852-6028
- Fax Number
- 508-721-7821
Provider Business Mailing Address Details
- Address
- 562 Lincoln St
Worcester, MA 01605-1916 - City
- Worcester
- State
- MA
- Zip
- 01605-1916
- Phone Number
- 508-852-6028
- Fax Number
- 508-721-7821
License Information
- License Number
- 21567
- License State
- MA
- Taxonomy
- Family Medicine, Adult Medicine · 207QA0505X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Family Medicine, Adult Medicine providers near Worcester, MA
View all Family Medicine, Adult Medicine providers in Worcester →Frequently Asked Questions
What is the NPI number of Anthony Distefano, Jr MD?
The NPI number of Anthony Distefano, Jr MD is 1063646552. It was assigned on May 12, 2009 and is currently active in the NPPES registry.
What is the specialty of Anthony Distefano, Jr MD?
Anthony Distefano, Jr MD is registered under the primary taxonomy Family Medicine, Adult Medicine (code 207QA0505X), licensed in MA under license number 21567.
Where does Anthony Distefano, Jr MD practice?
The practice location is 562 Lincoln St, Worcester, MA 01605-1916. The office can be reached at 508-852-6028 (phone) or 508-721-7821 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1063646552 directly on the NPPES registry website.