Anthony Destefano, is a
Psychologist - School based in Manorville, New York. Anthony Destefano is licensed to practice in New York (license number ) and his current practice location is
3 Carriage Path, Manorville, New York. He can be reached at his office (for appointments etc.) via phone at
(631) 878-8304.
NPI number for Anthony Destefano is 1710016902 and his current mailing address is 3 Carriage Path, Manorville, New York. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1710016902.
Healthcare Provider's Profile
| Full Name | Anthony Destefano |
|---|
| Gender | Male |
|---|
| Speciality | Psychologist - School |
|---|
| Location | 3 Carriage Path, Manorville, New York |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1710016902
- Provider Enumeration Date: 03/05/2007
- Last Update Date: 04/04/2008
Medical Identifiers
Medical identifiers for Anthony Destefano such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1710016902 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 001964-1 (New York) | Secondary |
| 103TS0200X | Psychologist - School | (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Anthony Destefano is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Anthony Destefano,
3 Carriage Path,
Manorville, NY 11949-2611
Ph: (516) 443-9877 | Anthony Destefano,
3 Carriage Path,
Manorville, NY 11949-2611
Ph: (631) 878-8304 |
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