DR. Kenneth Louis Distefano, MD
NPI #1619146677 in Verona, New Jersey
Provider Information
- NPI Number
- 1619146677
- Entity Type
- Individual
- Name
- DR. Kenneth Louis Distefano, MD
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Family Medicine
- Credential
- MD
- Enumeration Date
- Feb 25, 2008
- Last Updated
- Jan 5, 2011
Practice Location
- Address
- 1 MOUNT PROSPECT AVE
- City
- Verona
- State
- New Jersey
- ZIP Code
- 07044-2707
- Phone
- (973) 239-7777
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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