Destefano, Joseph Leonard

Destefano, Joseph Leonard is an individual health care provider with primary practice located at 1116 N 16Th St , Lafayette IN 47904-2119. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Destefano, Joseph Leonard can be contacted via phone (765) 423-6300.

Contact Information

Primary practice address
1116 N 16Th St Lafayette IN 47904-2119
Phone: (765) 423-6300
Fax: (765) 423-6301
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 01042109A Indiana

Profile Details

NPI number 1790928216
LBN Legal business name Destefano, Joseph Leonard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2009
Last updated Dec 28th, 2016 - about 8 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1790928216 NPPES
Indiana MEDICAID 201069420L
Indiana MEDICAID 200080730

Popular Providers