Doctor profile · Federal record
Dr. Kenneth Distefano, MD
Family Medicine Physician · Family Medicine Physician · Verona, NJ
- NPI 1619146677
- 18 yrs on file
- Licensed in 2 states
- Male
- Solo practice
- No sanctions
Practice & contact
- Primary practice
-
1 Mount Prospect Ave
Verona, NJ 070442707
(973) 239-7777
fax (973) 239-7082
Credentials & registration
- NPI registered
- February 2008 — 18 yrs on file
- Profile last updated
- January 5, 2011
- Specialty taxonomy
- 207Q00000X — NUCC code
- State licenses (2)
- New Jersey #25MA08855100 · New York #255630-1
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1619146677. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$142
Transactions
10
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| REVANCE THERAPEUTICS, INC. | 10 | $142.18 |
By nature of payment
Frequently asked questions
What is Dr. Kenneth Distefano's medical specialty?
Dr. Kenneth Distefano practices Family Medicine Physician in Verona, NJ.
Where does Dr. Kenneth Distefano practice?
Dr. Kenneth Distefano practices at 1 Mount Prospect Ave, Verona, NJ 070442707. Office phone: 9732397777.
What is Dr. Kenneth Distefano's NPI?
Dr. Kenneth Distefano's National Provider Identifier (NPI) is 1619146677, issued by NPPES.