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1609583145
JASON DISTEFANO
NORTHPORT, NY
NPI
1609583145
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: NY 050122)
Enumeration Date
2022-11-03
Last Update Date
2023-02-14
Business Address
JASON DISTEFANO DPT
389 FORT SALONGA RD
NORTHPORT, NY 11768-3089
Phone number: 631-261-0444
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Mailing Address
JASON DISTEFANO DPT
1311 MAMARONECK AVE STE 140
WHITE PLAINS, NY 10605-5224
Phone number:
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