Distefano, Richard J

Distefano, Richard J is an individual health care provider with primary practice located at 5719 Widewaters Pkwy , Syracuse NY 13214-1985. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine is his primary health care specialty. Distefano, Richard J can be contacted via phone (315) 251-3100.

Contact Information

Primary practice address
5719 Widewaters Pkwy Syracuse NY 13214-1985
Phone: (315) 251-3100
Fax: (315) 449-9923
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine 207XS0117X 187682 New York
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 187682 New York

Profile Details

NPI number 1972608586
LBN Legal business name Distefano, Richard J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2006
Last updated Apr 6th, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972608586 NPPES
New York MEDICAID 01556927

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