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

Michael Distefano

Individual provider Physical Therapist · NPI 1124647631

Michael Distefano is a Physical Therapist in Staten Island, New York. Practices as a sole proprietor and works from 2 locations. Licensed in New York.

Licensed in
NY
In the registry since
2020
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Practice location Address checks out

4711 Hylan Blvd
Staten Island, NY 10312-6311
Phone: (347) 739-3778
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4870 Hylan Blvd, Staten Island, NY 10312-6322 — (718) 200-4122

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 012677 (NY)

Record details

NPI number1124647631
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 14, 2020
Last updated in NPPESApril 14, 2020
Certification dateApril 14, 2020

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