Susan K Destefano, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

10869 Issued in CT

Practice address

20 York St
New Haven, CT 06510-3220

Phone

(203) 688-2207

Fax

(203) 688-9354

NPI assigned

Aug 19, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1225756752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 RONALD DR",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253627",
            "telephone_number": "203-231-3811",
            "fax_number": "203-688-9354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-2207",
            "fax_number": "203-688-9354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTEFANO",
        "first_name": "SUSAN",
        "middle_name": "K",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "10869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Francis Desouza, M.D.
• Dara Arshley Deborah Desrosiers, PA-C
• Mahalia S Desruisseaux, MD
• Sachi Desse
• Aydin Destan, PHARMD
• Desti Homecare Solutions LLC
• Destiny Life Partners, LLC
• Jalyn M Desunae, LCSW
• Maia Determan
• Ezra M Detroy, M.D.

• Gerontology Nurse Practitioner in New Haven, CT
• Providers in New Haven, CT by specialty
• Gerontology Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.