Individual
STEPHEN DIEFENDERFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-2000
Mailing address
588 LONGMEADOW ST, LONGMEADOW, MA 01106-2212
(413) 565-1000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/05/2022
Last updated
07/09/2024
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