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Mrs. Jody Leigh Destefano
Specialist in Lake Grove, New York
NPI 1912261488

Jody Leigh Destefano is a Specialist based in Lake Grove, NY. Jody Leigh Destefano practices in Lake Grove, NY. The NPI Number for Jody Leigh Destefano is 1912261488 and holds a License No. (New York).

The current practice location address for Jody Leigh Destefano is 9 Lindell Ave, Lake Grove, NY and can be reached out via phone at 631-285-1086.

Location: 9 Lindell Ave, Lake Grove, NY, 11755-3121
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1912261488
Provider Name
Jody Leigh Destefano
Credential
Provider Entity Type
Individual
Gender
Female
Address
9 Lindell Ave, Lake Grove, NY, 11755-3121
Phone Number
631-285-1086
Fax Number
Provider Enumeration Date
06/29/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
9 Lindell Ave
City
Lake Grove
State
New York
Zip
11755-3121
Phone Number
631-285-1086
Fax Number
person
Provider Business Mailing Address Details
Address
9 Lindell Ave
City
Lake Grove
State
New York
Zip
11755-3121
Phone Number
631-285-1086
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
()
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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