MR. Dominick A Destefano, A.T.,C
NPI #1053378067 in Southampton, New York
Provider Information
- NPI Number
- 1053378067
- Entity Type
- Individual
- Name
- MR. Dominick A Destefano, A.T.,C
- Gender
- Not Specified
- Sole Proprietor
- Not Answered
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- A.T.,C
- Enumeration Date
- Apr 26, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 1370A MAJORS PATH
- City
- Southampton
- State
- New York
- ZIP Code
- 11968-2416
- Phone
- (631) 259-0400
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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