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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790928216 | NPPES |
| Indiana | MEDICAID | 201069420L | |
| Indiana | MEDICAID | 200080730 |
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