Anthony Destefano

NPI #1710016902 in Manorville, New York

Provider Information

NPI Number: 1710016902
Entity Type: Individual
Name: Anthony Destefano
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist - School
Enumeration Date: Mar 5, 2007
Last Updated: Apr 4, 2008

Practice Location

Address: 3 CARRIAGE PATH
City: Manorville
State: New York
ZIP Code: 11949-2611
Phone: (631) 878-8304

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Psychologist - School — School	103TS0200X	Primary

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