Leo Joseph Distefano III MD

NPI 1760453724 - Pediatrics - 2080A0000X

NPI Details
NPI 1760453724
Gender Male
Enumeration Date 01/30/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
970 FARMINGTON AVENUE
SUITE 201
WEST HARTFORD CT, 06107, US
Phone (860) 561-4300
Fax (860) 561-1635
Business Location
970 FARMINGTON AVENUE
SUITE 201
WEST HARTFORD CT, 06107, US
Phone (860) 561-4300
Fax (860) 561-1635
Toxanomy
Taxonomy Code 2080A0000X
License State Connecticut
License Number 033656
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According to our database, Mr. Leo Joseph Distefano III MD NPI is 1760453724, taxonomy code is 2080A0000X and license number is 033656, license state is located at Connecticut. Leo Joseph Distefano III MD physically located at 970 Farmington Avenue, West Hartford CT, 06107. NPI Number Leo Joseph Distefano III MD has the Individual type.

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1760453724 NPI number is provided on an as is basis without warranty of any kind. 1760453724 is maintained by the National Plan & Provider Enumeration System. The contents of Leo Joseph Distefano III MD are for informational purposes only.