Kelly Distefano, MD
Anesthesiology in Elmwood Park, New Jersey
1679511000- Practice location
- 619 River Dr, Elmwood Park, NJ 07407-1317
- Phone
- 201-703-2900
- Fax
- —
- Last updated
- July 24, 2018
Kelly Distefano is an Anesthesiology based in Elmwood Park, NJ. Kelly Distefano practices in Elmwood Park, NJ and has the professional credentials of MD. The NPI Number for Kelly Distefano is 1679511000 and holds a License No. MA08068600 (NJ). The current practice location address for Kelly Distefano is 619 River Dr, Elmwood Park, NJ 07407-1317 and can be reached out via phone at 201-703-2900.
Provider Profile Details
- NPI Number
- 1679511000
- Provider Name
- Kelly Distefano
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 619 River Dr, Elmwood Park, NJ 07407-1317
- Phone Number
- 201-703-2900
- Primary Taxonomy
- Anesthesiology · 207L00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- June 4, 2006
- Last Update Date
- July 24, 2018
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 619 River Dr
Elmwood Park, NJ 07407-1317 - City
- Elmwood Park
- State
- New Jersey
- Zip
- 07407-1317
- Phone Number
- 201-703-2900
Provider Business Mailing Address Details
- Address
- Po Box 1849
Lewiston, ME 04241-1849 - City
- Lewiston
- State
- ME
- Zip
- 04241-1849
- Phone Number
- 207-784-2554
- Fax Number
- 207-777-1439
License Information
- License Number
- MA08068600
- License State
- NJ
- Taxonomy
- Anesthesiology · 207L00000X · 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 Kelly Distefano, MD?
The NPI number of Kelly Distefano, MD is 1679511000. It was assigned on June 4, 2006 and is currently active in the NPPES registry.
What is the specialty of Kelly Distefano, MD?
Kelly Distefano, MD is registered under the primary taxonomy Anesthesiology (code 207L00000X), licensed in NJ under license number MA08068600.
Where does Kelly Distefano, MD practice?
The practice location is 619 River Dr, Elmwood Park, NJ 07407-1317. The office can be reached at 201-703-2900 (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 1679511000 directly on the NPPES registry website.