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

Individual provider Psychologist · NPI 1710203393

Dr. Charles Destefano, PHD is a Psychologist in Staten Island, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2010
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

77 Governor Rd
Staten Island, NY 10314-3021 Not confirmed with CMS for 16 years — call before visiting
Phone: (718) 273-9179
Fax: (718) 273-9179
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 010175-1 (NY)

Record details

NPI number1710203393
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedApril 8, 2010
Last updated in NPPESApril 8, 2010

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