Individual
HEATHER ELIZABETH DIFEDERICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
101 CARTER RD, GENEVA, NY 14456-1053
(315) 781-0402
(315) 828-1790
Mailing address
101 CARTER RD, GENEVA, NY 14456-1092
(315) 781-0402
(315) 828-1790
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
643867
NY
Other
Enumeration date
05/02/2019
Last updated
05/02/2019
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