Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dominick Distasio

Individual provider Case Manager/Care Coordinator · NPI 1740714930

Dominick Distasio is a Case Manager/Care Coordinator in Smithtown, New York. Practices as a sole proprietor. Registered with an NPI since 2017.

In the registry since
2017

Practice location Address checks out

11 Route 111
Smithtown, NY 11787-3754
Phone: (631) 920-8028
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X

Record details

NPI number1740714930
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 14, 2017
Last updated in NPPESApril 14, 2017
Mailing address5 Hudson Dr, Kings Park, NY 11754-4411

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