| Anthony Distefano, Jr Md | |
|
562 Lincoln St Worcester MA 01605-1916 | |
| (508) 852-6028 | |
| (508) 721-7821 |
| Full Name | Anthony Distefano, Jr Md |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 562 Lincoln St, Worcester, Massachusetts |
| Authorized Official Name and Position | Anthony J Distefano (OWNER) |
| Authorized Official Contact | 5088526028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony Distefano, Jr Md 562 Lincoln St Worcester MA 01605-1916 Ph: (508) 852-6028 | Anthony Distefano, Jr Md 562 Lincoln St Worcester MA 01605-1916 Ph: (508) 852-6028 |
| NPI Number | 1063646552 |
|---|---|
| Provider Enumeration Date | 05/12/2009 |
| Last Update Date | 05/12/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063646552 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | 21567 (Massachusetts) | Primary |
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