Mr. Michael Distefano, MA, ATC, CSCS, PES
Specialist/Technologist, Athletic Trainer in Storrs, Connecticut
1558803551- Practice location
- 9 Dog Ln, Suite 108, Storrs, CT 06268-2239
- Phone
- 860-429-0899
- Fax
- —
- Last updated
- November 8, 2016
Michael Distefano is a Specialist/Technologist, Athletic Trainer based in Storrs, CT. Michael Distefano practices in Storrs, CT and has the professional credentials of MA, ATC, CSCS, PES. The NPI Number for Michael Distefano is 1558803551 and holds a License No. 000608 (CT). The current practice location address for Michael Distefano is 9 Dog Ln, Suite 108, Storrs, CT 06268-2239 and can be reached out via phone at 860-429-0899.
Provider Profile Details
- NPI Number
- 1558803551
- Provider Name
- Michael Distefano
- Credential
- MA, ATC, CSCS, PES
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 9 Dog Ln, Suite 108, Storrs, CT 06268-2239
- Phone Number
- 860-429-0899
- Primary Taxonomy
- Specialist/Technologist, Athletic Trainer · 2255A2300X
- Sole Proprietor
- No
- Provider Enumeration Date
- November 8, 2016
- Last Update Date
- November 8, 2016
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 9 Dog Ln
Suite 108
Storrs, CT 06268-2239 - City
- Storrs
- State
- Connecticut
- Zip
- 06268-2239
- Phone Number
- 860-429-0899
Provider Business Mailing Address Details
- Address
- 90 Jonathan Ln
Storrs Mansfield, CT 06268-2775 - City
- Storrs Mansfield
- State
- CT
- Zip
- 06268-2775
License Information
- License Number
- 000608
- License State
- CT
- Taxonomy
- Specialist/Technologist, Athletic Trainer · 2255A2300X · 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 Mr. Michael Distefano, MA, ATC, CSCS, PES?
The NPI number of Mr. Michael Distefano, MA, ATC, CSCS, PES is 1558803551. It was assigned on November 8, 2016 and is currently active in the NPPES registry.
What is the specialty of Mr. Michael Distefano, MA, ATC, CSCS, PES?
Mr. Michael Distefano, MA, ATC, CSCS, PES is registered under the primary taxonomy Specialist/Technologist, Athletic Trainer (code 2255A2300X), licensed in CT under license number 000608.
Where does Mr. Michael Distefano, MA, ATC, CSCS, PES practice?
The practice location is 9 Dog Ln, Suite 108, Storrs, CT 06268-2239. The office can be reached at 860-429-0899 (phone).
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 1558803551 directly on the NPPES registry website.