Jack V. Diteodoro M.d,llc
Point of Service in Stamford, Connecticut
1700194636- Practice location
- 90 Morgan Steet Stuite 303, Stamford, CT 06905-5436
- Phone
- 203-323-6873
- Fax
- —
- Last updated
- September 14, 2010
Jack V. Diteodoro M.d,llc is a healthcare organization based in Stamford, CT. Jack V. Diteodoro M.d,llc practices in Stamford, CT. The NPI Number for Jack V. Diteodoro M.d,llc is 1700194636 and holds a License No. 035558 (CT). The current practice location address for Jack V. Diteodoro M.d,llc is 90 Morgan Steet Stuite 303, Stamford, CT 06905-5436 and can be reached out via phone at 203-323-6873.
Provider Profile Details
- NPI Number
- 1700194636
- Provider Name
- Jack V. Diteodoro M.d,llc
- Provider Entity Type
- Organization
- Address
- 90 Morgan Steet Stuite 303, Stamford, CT 06905-5436
- Phone Number
- 203-323-6873
- Primary Taxonomy
- Point of Service · 305S00000X
- Organization Subpart
- No
- Authorized Official
- Dr. Jack V Diteodoro, MD · Owner · 203-323-6873
- Provider Enumeration Date
- September 14, 2010
- Last Update Date
- September 14, 2010
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 90 Morgan Steet Stuite 303
Stamford, CT 06905-5436 - City
- Stamford
- State
- Connecticut
- Zip
- 06905-5436
- Phone Number
- 203-323-6873
Provider Business Mailing Address Details
- Address
- 90 Morgan St Ste 303
Stamford, CT 06905-5436 - City
- Stamford
- State
- CT
- Zip
- 06905-5436
- Phone Number
- 203-323-6873
License Information
- License Number (1)
- 035558
- License State (1)
- CT
- Taxonomy (1)
- Exclusive Provider Organization · 302F00000X
- License Number (2)
- 035558
- License State (2)
- CT
- Taxonomy (2)
- Health Maintenance Organization · 302R00000X
- License Number (3)
- 035558
- License State (3)
- CT
- Taxonomy (3)
- Preferred Provider Organization · 305R00000X
- License Number (4)
- 035558
- License State (4)
- CT
- Taxonomy (4)
- Point of Service · 305S00000X · 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 Jack V. Diteodoro M.d,llc?
The NPI number of Jack V. Diteodoro M.d,llc is 1700194636. It was assigned on September 14, 2010 and is currently active in the NPPES registry.
What is the specialty of Jack V. Diteodoro M.d,llc?
Jack V. Diteodoro M.d,llc is registered under the primary taxonomy Point of Service (code 305S00000X), licensed in CT under license number 035558.
Where does Jack V. Diteodoro M.d,llc practice?
The practice location is 90 Morgan Steet Stuite 303, Stamford, CT 06905-5436. The office can be reached at 203-323-6873 (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 1700194636 directly on the NPPES registry website.