Vincent F Destasio DO

NPI 1043215650 - Family Medicine - 207Q00000X

NPI Details
NPI 1043215650
Gender Male
Enumeration Date 06/20/2005
Last Updated 07/10/2008
Entity Type Individual
Active Over 11 years ago
Practice Location
1851 HOOPER AVE
STA
TOMS RIVER NJ, 08753-8150, US
Phone (732) 255-6566
Fax (732) 255-3085
Business Location
1851 HOOPER AVE
STA
TOMS RIVER NJ, 08753-8150, US
Phone (732) 255-6566
Fax (732) 255-3085
Toxanomy
Taxonomy Code 207Q00000X
License State New Jersey
License Number MB51894
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According to our database, Mr. Vincent F Destasio DO NPI is 1043215650, taxonomy code is 207Q00000X and license number is MB51894, license state is located at New Jersey. Vincent F Destasio DO physically located at 1851 Hooper Ave, Toms River NJ, 08753-8150. NPI Number Vincent F Destasio DO has the Individual type.

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1043215650 NPI number is provided on an as is basis without warranty of any kind. 1043215650 is maintained by the National Plan & Provider Enumeration System. The contents of Vincent F Destasio DO are for informational purposes only.