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General NPI Number Information
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NPI Number | 1013257955
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Entity Type | Individual
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Provider Name | DANIELLE DIFEDE PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 02/28/2013
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Last Update Date | 02/28/2013
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Provider Practice Location Address
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Address Line | ONE GUSTAVE L. LEVY PLACE MOUNT SINAI HOSPITAL BOX 1116
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City | NEW YORK
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State | NY
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Zip | 10029-6574
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Country | US
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Telephone | 212-824-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 6203 N HEMPSTEAD TPKE
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City | EAST NORWICH
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State | NY
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Zip | 11732-1617
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Country | US
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Telephone | 516-660-8361
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 015951
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License Number State | NY
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