Jack V. Diteodoro M.d,llc
NPI #1700194636 in Stamford, Connecticut
Provider Information
- NPI Number
- 1700194636
- Entity Type
- Organization
- Organization Name
- Jack V. Diteodoro M.d,llc
- Primary Specialty
- Point of Service
- Enumeration Date
- Sep 14, 2010
- Last Updated
- Sep 14, 2010
Practice Location
- Address
- 90 MORGAN STEET STUITE 303
- City
- Stamford
- State
- Connecticut
- ZIP Code
- 06905-5436
- Phone
- (203) 323-6873
Authorized Official
- Name
- DR. JACK V DITEODORO, M.D.
- Title
- OWNER
- Phone
- (203) 323-6873
Specialties & Taxonomy Codes
| Specialty |
|---|
| Exclusive Provider Organization |
| Health Maintenance Organization |
| Preferred Provider Organization |
| Point of Service |
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