Leo Joseph Distefano in West Hartford - Adolescent Medicine
Leo Joseph Distefano - NPI 1760453724
Leo Joseph Distefano is a Adolescent Medicine in West Hartford, Connecticut. Leo Joseph Distefano practices all healthcare services and medical treatments related to Adolescent Medicine. The NPI Number for Leo Joseph Distefano is 1760453724. The last update date is 2007-07-08.
Leo Joseph Distefano's current location address is 970 Farmington Avenue, West Hartford, Connecticut. You can contact this provider via phone number 8605614300 and fax number 8605611635. The mailing address for Leo Joseph Distefano is 970 Farmington Avenue, West Hartford, Connecticut. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Leo Joseph Distefano |
|---|---|
| Address | 970 Farmington Avenue, West Hartford, Connecticut |
| Phone Number | 8605614300 |
| Fax Number | 8605611635 |
| Sole Proprietor | X |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1760453724 |
|---|---|
| Provider Enumeration Date | 2006-01-30 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 970 Farmington Avenue |
|---|---|
| City | West Hartford |
| State | Connecticut (CT) |
| Post Code | 6107 |
| Phone Number | 8605614300 |
| Fax Number | 8605611635 |
Provider's Primary Taxonomy Detail
| Speciality | Adolescent Medicine |
|---|---|
| Taxonomy | 2080A0000X |
| Licence No | 33656 |
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Definition: A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 735010 | CT | CONNECTICARE | |
| 133656100 | CT | -- | |
| 01003365CT01 | CT | ANTHEM BCBS |
Post Comment/ Review Below
What is the Leo Joseph Distefano's 1760453724?
The Leo Joseph Distefano's NPI (National Provider Identifier) Number is 1760453724. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Leo Joseph Distefano?
The Leo Joseph Distefano is physically situated at 970 Farmington Avenue, in the city of West Hartford, state of CT, with the postal code 6107.
What is the Leo Joseph Distefano's specialty and taxonomy code?
The Leo Joseph Distefano's specialty is Adolescent Medicine, and the corresponding taxonomy code is 2080A0000X.
When was the Leo Joseph Distefano's 1760453724 issued?
The Leo Joseph Distefano's 1760453724 was issued on 2006-01-30.
When was the information pertaining to Leo Joseph Distefano most recently updated or revised?
The details related to Leo Joseph Distefano, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.