Individual
KELLY ANN DIFABIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1825 RTE 35, WALL TOWNSHIP, NJ 07719-3541
(732) 280-2600
Mailing address
83 VANARD DR, BRICK, NJ 08723-7441
(610) 203-5910
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MB10085300
NJ
Other
Enumeration date
06/14/2013
Last updated
01/19/2018
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