Lisa Nicole Destefano

NPI #1437497526 in South Hadley, Massachusetts

Provider Information

NPI Number: 1437497526
Entity Type: Individual
Name: Lisa Nicole Destefano
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Jan 23, 2013
Last Updated: Jan 23, 2013

Practice Location

Address: 30 OLD LYMAN RD
City: South Hadley
State: Massachusetts
ZIP Code: 01075-2630
Phone: (413) 533-7140

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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