Nilla Defazio in Montclair - Physician Assistant
Nilla Defazio - NPI 1336100486
Nilla Defazio is a Physician Assistant in Montclair, New Jersey. Nilla Defazio practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Nilla Defazio is 1336100486. The last update date is 2007-07-08.
Nilla Defazio's current location address is 1 Bay Ave, Montclair, New Jersey. You can contact this provider via phone number 9734296695. The mailing address for Nilla Defazio is 1 Bay Ave, Montclair, New Jersey. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Nilla Defazio |
|---|---|
| Address | 1 Bay Ave, Montclair, New Jersey |
| Phone Number | 9734296695 |
| Fax Number | |
| Sole Proprietor | X |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1336100486 |
|---|---|
| Provider Enumeration Date | 2006-03-29 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1 Bay Ave |
|---|---|
| City | Montclair |
| State | New Jersey (NJ) |
| Post Code | 70424837 |
| Phone Number | 9734296695 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 25MP00034900 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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What is the unique provider identifier assigned to Nilla Defazio?
The Nilla Defazio has been issued the NPI (National Provider Identifier) 1336100486 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Nilla Defazio?
The Nilla Defazio is situated at 1 Bay Ave, in the city of Montclair, state of NJ, with the zip code 70424837.
What is Nilla Defazio's area of expertise and its corresponding taxonomy classification?
The Nilla Defazio's field of specialization is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1336100486 to Nilla Defazio?
The Centers for Medicare & Medicaid Services originally issued the 1336100486 to Nilla Defazio on 2006-03-29.
When was the information regarding Nilla Defazio, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Nilla Defazio, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.
NPI Number: 1073517686
Address: 2100 Martin Luther King Jr Blvd, Clovis, NM