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Individual

DR. GREGORY SCOTT DIFELICE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
535 E 70TH ST, NEW YORK, NY 10021
(212) 606-1844
(212) 746-8744
Mailing address
535 E 70TH ST, NEW YORK, NY 10021-4823
(212) 606-1844
(212) 746-8744

Taxonomy

Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
202532
NY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
202532
NY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
25MA09393500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02152321
NY
01
202532
STATE LICENSE
NY
01
25MA09393500
STATE LICENSE
NJ
Enumeration date
03/16/2006
Last updated
05/16/2025
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