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JACK V. DITEODORO M.D,LLC
NPI 1700194636
Point of Service in Stamford, CT

Active since September 14, 2010
90 MORGAN STEET STUITE 303, STAMFORD, CT 06905(203) 323-6873 Get Directions Write a Review

NPPES record last updated: September 14, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jack V. Diteodoro M.d,llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK V. DITEODORO M.D,LLC (NPI 1700194636) is a healthcare organization registered as a point of service in Stamford, Connecticut and active in the NPI registry since September 2010. The organization lists Jack V Diteodoro, Owner, as its authorized official.

NPPES Registry Identity

NPI1700194636
Entity TypeOrganization
Primary Taxonomy305S00000X
Legal Business NameJACK V. DITEODORO M.D,LLC
Location Address90 MORGAN STEET STUITE 303Stamford, CT 06905-5436
Mailing Address90 Morgan St Ste 303Stamford, CT 06905-5436 · (203) 323-6873
Phone(203) 323-6873
Organization SubpartNo
Authorized OfficialJack V DiteodoroOwner · (203) 323-6873
Enumeration DateSeptember 14, 2010
✔ NPI 1700194636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPoint of ServiceManaged Care Organizations
Taxonomy Code305S00000X
License✔ Licensed in CT · 035558
Definition

This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.

Also ListedExclusive Provider OrganizationTaxonomy 302F00000X · License 035558 (CT)
Also ListedHealth Maintenance OrganizationTaxonomy 302R00000X · License 035558 (CT)
Also ListedPreferred Provider OrganizationTaxonomy 305R00000X · License 035558 (CT)
90 MORGAN STEET STUITE 303, Stamford, CT 06905
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Other Identifiers 2

Medicare UPING43319CT
Medicaid001355587CT

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack V. Diteodoro M.D,llc's NPI number?

The NPI number for Jack V. Diteodoro M.D,llc is 1700194636. It was assigned to this organization in the NPPES registry on September 14, 2010.

Where is Jack V. Diteodoro M.D,llc located?

Jack V. Diteodoro M.D,llc is located at 90 Morgan Steet Stuite 303, Stamford, CT 06905. The listed phone number is (203) 323-6873.

What is Jack V. Diteodoro M.D,llc's specialty?

The primary specialty registered for this NPI is Point of Service with taxonomy code 305S00000X.

When was this NPI record last updated?

The NPPES record for Jack V. Diteodoro M.D,llc was last updated on September 14, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.