Individual
MRS. DIANE ALEXANDER DIFAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CPNP
Contact information
Practice address
3 COOPER PLZ, CAMDEN, NJ 08103-1438
(856) 342-2000
Mailing address
3 COOPER PLZ, CAMDEN, NJ 08103-1438
(856) 342-2000
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
NN72874
NJ
363LP0200X
Pediatric Nurse Practitioner
SP004652N
PA
Other
Enumeration date
07/16/2007
Last updated
11/13/2014
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