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
Phone: (732) 255-6566
Fax: (732) 255-3085
Website:
Health care specialties
| Specialty | Code | License # | 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 2 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 | 1043215650 | NPPES |
| New Jersey | Other | D04846300 | CDS |
| New Jersey | MEDICAID | 5453208 | CDS |
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