Destafeno, John J
Destafeno, John J is an individual health care provider with primary practice located at 915 Old Fern Hill Rd Bldg B Ste 200 , West Chester PA 19380-4269. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Uveitis and Ocular Inflammatory Disease. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Destafeno, John J can be contacted via phone (610) 696-1230.Contact Information
Primary practice address
915 Old Fern Hill Rd Bldg B Ste 200
West Chester PA 19380-4269
Phone: (610) 696-1230
Fax: (610) 696-2341
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 2005-00363 | North Carolina |
| Allopathic & Osteopathic Physicians / Uveitis and Ocular Inflammatory Disease | 207WX0108X | MD431622 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | MD431622 | Pennsylvania |
Profile Details
| NPI number | 1912097171 |
|---|---|
| LBN Legal business name | Destafeno, John J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 16th, 2006 |
| Last updated | Oct 9th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912097171 | NPPES |
| North Carolina | MEDICAID | 5901401 | |
| North Carolina | MEDICAID | 1019183240001 |
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