Cathy Distefano, OMT

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

018374 Issued in NY

Practice address

5 Wimbledon CT
Woodbury, NY 11797-2411

Phone

(516) 510-1157

NPI assigned

Feb 9, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1881193407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 WIMBLEDON CT",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972411",
            "telephone_number": "516-510-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 WIMBLEDON CT",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972411",
            "telephone_number": "516-510-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTEFANO",
        "first_name": "CATHY",
        "name_prefix": "Ms.",
        "credential": "OMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-09",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NY",
            "license": "018374-1",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NY",
            "license": "018374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9478748",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018374",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018374-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMT",
            "identifier": "018374",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Denner, LMHC
• Smina Desai
• Julie Desimone, D.M.D.
• Milagros Diaz, MD
• Heidi Dawn Dietl
• Jessica Dizinno
• Carolyn G Dombrowski, NPP
• Sarah Donohue, PA
• Dr Jill L Strominger, DC,PC
• Dr. Ashley Boccio DPM, PLLC

• Dental Hygienist in Woodbury, NY
• Providers in Woodbury, NY by specialty
• Dental Hygienist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.