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

Dr. Jack V Diteodoro, MD

Individual provider General Practice Physician · NPI 1346338837

Dr. Jack V Diteodoro, MD is a Family Practice in Stamford, Connecticut. Qualified in 1987, 39 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
39
Licensed in
CT
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

90 Morgan St Sutie # 303
Stamford, CT 06905-5466
Phone: (203) 323-6873
Fax: (203) 358-9775
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 035558 (CT)
General Practice Physician Taxonomy 208D00000X · Licence 035558 (CT)

Record details

NPI number1346338837
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedOctober 10, 2006
Last updated in NPPESOctober 3, 2010
Mailing address90 Morgan St, Sutie # 303, Stamford, CT 06905-5466

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1987 (39 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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