Individual
GINA DIFUSCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
20 RIDGE LN, MAHOPAC, NY 10541-1415
(845) 222-8587
Mailing address
20 RIDGE LN, MAHOPAC, NY 10541-1415
(845) 222-8587
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86150783
—
133V00000X
Registered Dietitian
—
—
Other
Enumeration date
12/05/2020
Last updated
11/01/2023
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