Destasio, Vincent F

Destasio, Vincent F is an individual health care provider with primary practice located at 1851 Hooper Ave Sta, Toms River NJ 08753-8150. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Destasio, Vincent F can be contacted via phone (732) 255-6566.

Contact Information

Primary practice address
1851 Hooper Ave Sta Toms River NJ 08753-8150
Fax: (732) 255-3085
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MB51894 New Jersey

Profile Details

NPI number 1043215650
LBN Legal business name Destasio, Vincent F
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Mar 7th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043215650 NPPES
New Jersey Other D04846300 CDS
New Jersey MEDICAID 5453208 CDS

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