MEDICARE: DIFIORE ENTERPRISES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	152WC0802X	NJ

General Provider Information

NPI Number	:	1679750632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIFIORE ENTERPRISES INC.

Provider Business Mailing Address
First Line	:	3223 ROUTE 38
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-9746
Country	:	US
Telephone Number	:	856-234-7881
Fax Number	:	856-234-1395

Provider Business Practice Location Address
First Line	:	3223 ROUTE 38
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-9746
Country	:	US
Telephone Number	:	856-234-7881
Fax Number	:	856-234-1395

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PAUL D. DIFIORE
Credential	:	O.D.
Telephone Number	:	856-234-7881

Provider Enumeration Date	:	01/22/2008
Last Update Date	:	02/13/2009

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