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1629141544
ED J DESTEFANO
PHILADELPHIA, PA
NPI
1629141544
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: PA RN259564L)
Enumeration Date
2006-11-16
Last Update Date
2014-10-01
Business Address
-- ED J DESTEFANO CRNA
777 APPLETREE ST 7TH FLOOR
PHILADELPHIA, PA 19106-1526
Phone number: 856-356-4025
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Mailing Address
-- ED J DESTEFANO CRNA
601 CHAPEL AVE E
CHERRY HILL, NJ 08034-1454
Phone number: 856-356-4025
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