Michael Charles Distefano, MD
Orthopaedic Surgery in Paramus, NJ. Individual provider (NPI-1).
NPI number1407883887
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1407883887
- Entity type
- Individual (NPI-1)
- Name
- Michael Charles Distefano
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 28, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | MA04126600 | NJ | Yes |
Practice location
140 Route 17 NorthSuite 255
Paramus, NJ 07652
Phone 201-261-5501 · Fax 201-261-3350
Mailing address
140 Route 17 NorthSuite 255
Paramus, NJ 07652
Phone 201-261-5501 · Fax 201-261-3350
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