Dr. Kenneth L Distefano Sr., MD
Plastic Surgery in Verona, New Jersey
1346324852- Practice location
- 1 Mount Prospect Ave, Verona, NJ 07044-2707
- Phone
- 973-239-7777
- Fax
- 973-239-7082
- Last updated
- September 6, 2023
Kenneth L Distefano is a Plastic Surgery based in Verona, NJ. Kenneth L Distefano practices in Verona, NJ and has the professional credentials of MD. The NPI Number for Kenneth L Distefano is 1346324852 and holds a License No. 25ma02454300 (NJ). The current practice location address for Kenneth L Distefano is 1 Mount Prospect Ave, Verona, NJ 07044-2707 and can be reached out via phone at 973-239-7777 and via fax at 973-239-7082.
Provider Profile Details
- NPI Number
- 1346324852
- Provider Name
- Kenneth L Distefano
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 1 Mount Prospect Ave, Verona, NJ 07044-2707
- Phone Number
- 973-239-7777
- Fax Number
- 973-239-7082
- Primary Taxonomy
- Plastic Surgery · 208200000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- October 24, 2006
- Last Update Date
- September 6, 2023
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1 Mount Prospect Ave
Verona, NJ 07044-2707 - City
- Verona
- State
- New Jersey
- Zip
- 07044-2707
- Phone Number
- 973-239-7777
- Fax Number
- 973-239-7082
Provider Business Mailing Address Details
- Address
- 1 Mount Prospect Ave
Verona, NJ 07044-2707 - City
- Verona
- State
- NJ
- Zip
- 07044-2707
- Phone Number
- 973-239-7777
- Fax Number
- 973-239-7082
License Information
- License Number
- 25ma02454300
- License State
- NJ
- Taxonomy
- Plastic Surgery · 208200000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Kenneth L Distefano Sr., MD?
The NPI number of Dr. Kenneth L Distefano Sr., MD is 1346324852. It was assigned on October 24, 2006 and is currently active in the NPPES registry.
What is the specialty of Dr. Kenneth L Distefano Sr., MD?
Dr. Kenneth L Distefano Sr., MD is registered under the primary taxonomy Plastic Surgery (code 208200000X), licensed in NJ under license number 25ma02454300.
Where does Dr. Kenneth L Distefano Sr., MD practice?
The practice location is 1 Mount Prospect Ave, Verona, NJ 07044-2707. The office can be reached at 973-239-7777 (phone) or 973-239-7082 (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 1346324852 directly on the NPPES registry website.